Provider Demographics
NPI:1437365475
Name:HOUTCHENS, KATHRYN DYMAK (MA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DYMAK
Last Name:HOUTCHENS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:970-339-9651
Mailing Address - Fax:
Practice Address - Street 1:8321 SANGRE DE CRISTO RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6425
Practice Address - Country:US
Practice Address - Phone:303-984-4414
Practice Address - Fax:303-984-6244
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO237600000X
COAUD333231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAUD333OtherAUDIOLOGY LIC
COCO304938Medicare UPIN