Shine Speech Language Pathology LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000368 Issued in CO

Legal business name

SHINE SPEECH LANGUAGE PATHOLOGY LLC

Practice address

209 Nelson St
Erie, CO 80516-2516

Phone

(303) 596-4113

NPI assigned

Jul 28, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charlene Christianson

Title

Owner

Phone

(303) 596-4113

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1073998324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 NELSON ST",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162516",
            "telephone_number": "303-596-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 NELSON ST",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805162516",
            "telephone_number": "303-596-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE SPEECH LANGUAGE PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "CHRISTIANSON",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-596-4113"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0000368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Erie, CO
• Providers in Erie, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.