Provider Demographics
NPI:1639424096
Name:ADKISSON, MARIN (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARIN
Middle Name:
Last Name:ADKISSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 UNION BLVD
Mailing Address - Street 2:SUITE 421
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1830
Mailing Address - Country:US
Mailing Address - Phone:720-446-2828
Mailing Address - Fax:720-446-0941
Practice Address - Street 1:200 UNION BLVD
Practice Address - Street 2:SUITE 421
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1830
Practice Address - Country:US
Practice Address - Phone:720-446-2828
Practice Address - Fax:720-446-0941
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO661231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter