Basic Information
| Provider Information | |||||||||
| NPI: | 1225382237 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDSON | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4900 S MONACO ST | ||||||||
| Address2: | #210 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802373486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033019019 | ||||||||
| FaxNumber: | 3038616254 | ||||||||
| Practice Location | |||||||||
| Address1: | 2055 HIGH ST | ||||||||
| Address2: | #110 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802055503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033019019 | ||||||||
| FaxNumber: | 3038616254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2012 | ||||||||
| LastUpdateDate: | 02/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 662 | CO | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 1225382237 | 05 | NE | MEDICAID | 201073330A | 05 | KS | MEDICAID | 27377776 | 05 | CO | MEDICAID | 1225382237 | 05 | WY | MEDICAID |