Provider Demographics
NPI:1114795937
Name:WARMAN, KRISTEN MARIE (MCD CCC SLP)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MARIE
Last Name:WARMAN
Suffix:
Gender:F
Credentials:MCD CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 BOARDWALK DR APT D103
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6230
Mailing Address - Country:US
Mailing Address - Phone:205-475-5454
Mailing Address - Fax:
Practice Address - Street 1:1025 9TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4039
Practice Address - Country:US
Practice Address - Phone:205-475-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0003926235Z00000X
14334732235Z00000X
CO24374729235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist