Provider Demographics
NPI:1154205946
Name:SRAMEK, MARY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SRAMEK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 S ATCHISON WAY APT 302
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4126
Mailing Address - Country:US
Mailing Address - Phone:518-836-4006
Mailing Address - Fax:
Practice Address - Street 1:2601 SABLE BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-2418
Practice Address - Country:US
Practice Address - Phone:518-836-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPLSP.0001216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist