Provider Demographics
NPI:1346537123
Name:PITTMAN, KATHRYN RAE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RAE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:RAE
Other - Last Name:GUERTTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:1829 DENVER WEST DR # 27
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3120
Mailing Address - Country:US
Mailing Address - Phone:303-982-6500
Mailing Address - Fax:
Practice Address - Street 1:200 KIPLING ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7425
Practice Address - Country:US
Practice Address - Phone:303-982-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO259224235Z00000X
12106281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist