Provider Demographics
NPI:1336645480
Name:FLEGAL, KRISTI DEY
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:DEY
Last Name:FLEGAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S LOWELL BLVD APT 9-303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-2430
Mailing Address - Country:US
Mailing Address - Phone:510-676-2041
Mailing Address - Fax:
Practice Address - Street 1:9197 W 6TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5109
Practice Address - Country:US
Practice Address - Phone:303-233-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-28902103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst