Basic Information
| Provider Information | |||||||||
| NPI: | 1447408661 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RADER | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | SCARLOTTA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6982 SECREST CT | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800077650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7209852972 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1660 S ALBION ST | ||||||||
| Address2: | #425 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802224008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202142549 | ||||||||
| FaxNumber: | 3037447876 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2008 | ||||||||
| LastUpdateDate: | 09/10/2014 | ||||||||
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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 | 538 | CO | Y | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | AU 2999 | CA | N | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.