Provider Demographics
NPI:1558608596
Name:SANTILLANA, KAITLYN J (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:J
Last Name:SANTILLANA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 QUENTIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-4312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:720-302-1185
Practice Address - Street 1:5730 WARD RD STE 101B
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1300
Practice Address - Country:US
Practice Address - Phone:720-908-2181
Practice Address - Fax:720-302-1185
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0000581235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist