Provider Demographics
NPI:1629450259
Name:KOLDEN, KIMBERLI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLI
Middle Name:
Last Name:KOLDEN
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 1:110 W ARCHER PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1620
Mailing Address - Country:US
Mailing Address - Phone:303-956-0641
Mailing Address - Fax:
Practice Address - Street 1:110 W ARCHER PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1620
Practice Address - Country:US
Practice Address - Phone:303-956-0641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0003080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist