Provider Demographics
NPI:1679711923
Name:STRAYER, KRISTINE (CCC)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:STRAYER
Suffix:
Gender:F
Credentials:CCC
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:
Other - Last Name:LEEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9900 EAST ILIFF AVE.
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231
Mailing Address - Country:US
Mailing Address - Phone:303-641-4136
Mailing Address - Fax:
Practice Address - Street 1:9900 EAST ILIFF AVE.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231
Practice Address - Country:US
Practice Address - Phone:303-641-4136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
12121295OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION