Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Colleen Rose Witt Bonnicksen, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1174951164

Colleen Rose Witt Bonnicksen, MSCCC-SLP is a Speech-Language Pathologist in Missoula, Montana. Practices as a sole proprietor. Licensed in Colorado, Massachusetts and Missouri.

Licensed in
CO, MA, MO
In the registry since
2013
Specialties on file
3
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Practice location Address checks out

6121 Coburg Ln
Missoula, MT 59803-9501
Phone: (499) 933-4152
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2019031366 (MO)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 0001571 (CO)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 8963 (MA)

Record details

NPI number1174951164
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorYes
NPI enumeratedOctober 29, 2013
Last updated in NPPESFebruary 19, 2020
Certification dateFebruary 19, 2020

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