Provider Demographics
NPI:1538955620
Name:WIDMEYER, CARLAH PAMELA
Entity type:Individual
Prefix:
First Name:CARLAH
Middle Name:PAMELA
Last Name:WIDMEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7341 S GLENCOE WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2530
Mailing Address - Country:US
Mailing Address - Phone:713-805-3759
Mailing Address - Fax:
Practice Address - Street 1:5776 S CROCKER ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2012
Practice Address - Country:US
Practice Address - Phone:303-457-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO244967527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist