Provider Demographics
NPI:1033405717
Name:TENBUS, COLLEEN KATHRYN (CCC-SLP (SPEECH LANG)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:KATHRYN
Last Name:TENBUS
Suffix:
Gender:F
Credentials:CCC-SLP (SPEECH LANG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:GRAHMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12740
Mailing Address - Country:US
Mailing Address - Phone:845-701-7966
Mailing Address - Fax:
Practice Address - Street 1:TRI-VALLEY CENTRAL SCHOOL
Practice Address - Street 2:34 MOORE HILL ROAD
Practice Address - City:GRAHAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12740
Practice Address - Country:US
Practice Address - Phone:845-985-2296
Practice Address - Fax:845-985-2481
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist