Individual
STEPHANIE HOLMSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
777 BANNOCK ST # B146, DENVER, CO 80204-4507
(303) 602-1588
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000756
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000756
DORA
CO
Enumeration date
06/12/2019
Last updated
06/12/2019
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