Provider Demographics
NPI:1598104135
Name:WINICOUR, KRISTINA LOUISE
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LOUISE
Last Name:WINICOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LOUISE
Other - Last Name:KOENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5130 W 80TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4450
Mailing Address - Country:US
Mailing Address - Phone:303-487-1532
Mailing Address - Fax:303-379-3922
Practice Address - Street 1:5130 W 80TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4450
Practice Address - Country:US
Practice Address - Phone:303-487-1532
Practice Address - Fax:303-379-3922
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist