Provider Demographics
NPI:1376768051
Name:KURTIN, LIA KATHRYN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LIA
Middle Name:KATHRYN
Last Name:KURTIN
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:LIA
Other - Middle Name:KATHRYN
Other - Last Name:ALBANESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13160 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2212
Mailing Address - Country:US
Mailing Address - Phone:303-929-3292
Mailing Address - Fax:
Practice Address - Street 1:13160 W 21ST AVE
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2212
Practice Address - Country:US
Practice Address - Phone:303-929-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ543117Medicaid