Provider Demographics
NPI:1407849557
Name:RAT KIEWICZ, BRENDA JANE (CCCA)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JANE
Last Name:RAT KIEWICZ
Suffix:
Gender:F
Credentials:CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 HALE PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3724
Mailing Address - Country:US
Mailing Address - Phone:303-322-1871
Mailing Address - Fax:303-399-3411
Practice Address - Street 1:4280 HALE PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3724
Practice Address - Country:US
Practice Address - Phone:303-322-1871
Practice Address - Fax:303-399-3411
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO427231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist