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Individual

JARED BRAUCHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CCC-SLP

Contact information

Practice address
2407 LAPORTE AVE, FORT COLLINS, CO 80521-2211
(970) 488-4222
Mailing address
2407 LAPORTE AVE, FORT COLLINS, CO 80521-2211

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003396
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000142570
CO
Enumeration date
11/05/2019
Last updated
01/25/2024
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