Individual
MRS. TINA LEE FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
715 SANDPOINT DR, LONGMONT, CO 80501-2300
(303) 775-4492
Mailing address
715 SANDPOINT DR, LONGMONT, CO 80501-2300
(303) 775-4492
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38479222
—
CO
Enumeration date
10/02/2006
Last updated
07/09/2007
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