Provider Demographics
NPI:1164754677
Name:KRATZER, EILEEN SULLIVAN (MA, DEAF EDUCATION)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:SULLIVAN
Last Name:KRATZER
Suffix:
Gender:F
Credentials:MA, DEAF EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 NEWLAND ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80214-8035
Mailing Address - Country:US
Mailing Address - Phone:303-232-1057
Mailing Address - Fax:
Practice Address - Street 1:2825 NEWLAND ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80214-8035
Practice Address - Country:US
Practice Address - Phone:303-232-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0453709235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist