Organization
GREY MATTER SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA LEE (OWNER/SLP)
(970) 286-7350
Entity
Organization
Contact information
Practice address
4816 KEY LARGO DR, FORT COLLINS, CO 80526-4634
(970) 286-7350
Mailing address
4816 KEY LARGO DR, FORT COLLINS, CO 80526-4634
(970) 286-7350
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811215148
INDIVIDUAL NPI (TYPE 1)
—
Enumeration date
03/17/2020
Last updated
04/07/2020
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