Provider Demographics
NPI:1629846746
Name:KERNS, HALLY ALLENA
Entity type:Individual
Prefix:MRS
First Name:HALLY
Middle Name:ALLENA
Last Name:KERNS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:HALLY
Other - Middle Name:ALLENA
Other - Last Name:RICKLEFS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2375 TELSTAR DR STE 160
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1043
Mailing Address - Country:US
Mailing Address - Phone:719-305-8900
Mailing Address - Fax:
Practice Address - Street 1:2375 TELSTAR DR STE 160
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1043
Practice Address - Country:US
Practice Address - Phone:719-305-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14380106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist