Most Relevant Information
Provider Data
| NPI Number: | 1003434382 |
| Provider Name: | AMY NICOLE VALLEJOS CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/13/2020 |
| Last Updated: | 07/13/2020 |
Provider Practice Location
615 RUSSELL STREET
WALSENBURG
CO
810892127
Practice Location Phone/Fax
| Phone: | 7196957300 |
| Fax: |
Provider Mailing Location
212 SPROULL AVE
WALSENBURG
CO
810891338
Provider Mailing Phone/Fax
| Phone: | 7199890726 |
| Fax: |