1457576225 NPI number — MRS. AMBER LEIGH HALES M.S., CCC-SLP

Table of content: MRS. AMBER LEIGH HALES M.S., CCC-SLP (NPI 1457576225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457576225 NPI number — MRS. AMBER LEIGH HALES M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALES
Provider First Name:
AMBER
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LORD
Provider Other First Name:
AMBER
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457576225
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5750 DTC PARKWAY
Provider Second Line Business Mailing Address:
SUITE 170
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-5483
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-504-9945
Provider Business Mailing Address Fax Number:
303-504-9946

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5750 DTC PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
GREENWOOD VILLAGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80111-5483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-504-9945
Provider Business Practice Location Address Fax Number:
303-504-9946
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 29577039 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 649046 . This is a "ANTHEM" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 841465539 . This is a "TAX ID" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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