Provider Demographics
NPI:1598355133
Name:VAVER, KRISTIN NICHOLAS (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICHOLAS
Last Name:VAVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 POPPY CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9388
Mailing Address - Country:US
Mailing Address - Phone:303-665-5153
Mailing Address - Fax:
Practice Address - Street 1:1068 S 88TH ST STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9459
Practice Address - Country:US
Practice Address - Phone:720-373-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2473103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation