Buck Jack LLC

NPI #1932712056 in Monument, Colorado

Provider Information

NPI Number: 1932712056
Entity Type: Organization
Organization Name: Buck Jack LLC
Primary Specialty: Speech-Language Pathologist
Enumeration Date: Aug 28, 2020
Last Updated: Feb 28, 2024

Practice Location

Address: 17230 JACKSON CREEK PKWY STE 220
City: Monument
State: Colorado
ZIP Code: 80132-7304
Phone: (719) 488-3348

Authorized Official

Name: TANNER DENN
Title: CREDENTIALING SPECIALIST
Phone: (719) 428-1840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X
Psychologist	103T00000X
Physical Therapist	225100000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X	Primary

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Alexandria Portillo, MA, SLP-CCC	Speech-Language Pathologist	Monument	AI Deep Dive
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