Provider Demographics
NPI:1265641641
Name:KIRTON, SUE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:
Last Name:KIRTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 WISP CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-2349
Mailing Address - Country:US
Mailing Address - Phone:303-359-9517
Mailing Address - Fax:303-838-5454
Practice Address - Street 1:701 E HAMPDEN AVE STE 415
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2759
Practice Address - Country:US
Practice Address - Phone:303-359-9517
Practice Address - Fax:303-788-5469
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO01063692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist