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Search › Colorado › 104100000X

Skylar Provencher, BT

NPI 1386309466 · on the registry since 2021

Practice

Address
2761 Janitell Rd
Colorado Springs, CO 80906
Phone
(719) 597-0822
Organisation at this address
Buck Jack Llc
Buck Jack, Llc
Buck Jack, Llc
Amy Shandy Speech Language Pathology
Inferred from a shared address, not stated in the registry.
Clinicians at this address
102

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
NC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-09-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado