Provider Demographics
NPI:1679753925
Name:SWEET TALK SPEECH-LANGUAGE PATHOLOGY
Entity type:Organization
Organization Name:SWEET TALK SPEECH-LANGUAGE PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MONTESANO
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP, MT-BC
Authorized Official - Phone:303-882-3123
Mailing Address - Street 1:6505 KALUA RD APT 203
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-5809
Mailing Address - Country:US
Mailing Address - Phone:303-882-3123
Mailing Address - Fax:
Practice Address - Street 1:6505 KALUA RD APT 203
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-5809
Practice Address - Country:US
Practice Address - Phone:303-882-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-04
Last Update Date:2007-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty