Individual
STACIE IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
700 BRAMBLEBUSH STREET, FORT COLLINS, CO 80524-2199
(970) 214-3677
Mailing address
700 BRAMBLEBUSH ST, FORT COLLINS, CO 80524-2199
(970) 214-3677
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0001614
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77809831
—
NM
05
—
Z 1275
—
NM
Enumeration date
04/03/2007
Last updated
10/20/2014
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