Individual
NANCY SUSAN GANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
3265 34TH ST, #59, BOULDER, CO 80301-1964
(303) 532-9545
Mailing address
3265 34TH ST, #59, BOULDER, CO 80301-1964
(303) 532-9545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12045725
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20336284
—
CO
05
—
44801068
—
CO
Enumeration date
08/20/2006
Last updated
07/09/2007
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