Provider Demographics
NPI:1174719603
Name:MADRID, KIRSTEN MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:MARIE
Last Name:MADRID
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Other - First Name:
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Mailing Address - Street 1:2674 E 131ST PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2056
Mailing Address - Country:US
Mailing Address - Phone:303-280-5283
Mailing Address - Fax:720-872-1413
Practice Address - Street 1:2674 E 131ST PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2056
Practice Address - Country:US
Practice Address - Phone:303-280-5283
Practice Address - Fax:720-872-1413
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist