Provider Demographics
NPI:1487196564
Name:GARST, KRISTIN (AUD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:GARST
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13952 DENVER WEST PKWY
Mailing Address - Street 2:STE 325
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3143
Mailing Address - Country:US
Mailing Address - Phone:720-974-9757
Mailing Address - Fax:
Practice Address - Street 1:2643 PATTERSON RD
Practice Address - Street 2:SUITE 503
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1936
Practice Address - Country:US
Practice Address - Phone:970-245-2400
Practice Address - Fax:970-242-9092
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0000828231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAUD.0000828OtherCOLORADO LICENSE