Individual
JACOB RYAN DESLONGCHAMPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
1143 IVY ST, DENVER, CO 80220-4542
(720) 318-4615
Mailing address
1143 IVY ST, DENVER, CO 80220-4542
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0005701
CO
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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