Provider Demographics
NPI:1760867089
Name:SHYAM, RAMYA (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:RAMYA
Middle Name:
Last Name:SHYAM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CENTURY CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9729
Mailing Address - Country:US
Mailing Address - Phone:720-738-8738
Mailing Address - Fax:720-862-2184
Practice Address - Street 1:275 CENTURY CIR STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9729
Practice Address - Country:US
Practice Address - Phone:720-738-8738
Practice Address - Fax:720-862-2184
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist