Provider Demographics
NPI:1679902506
Name:GREENE, KRISTY NICOLE (CCC, MS)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:NICOLE
Last Name:GREENE
Suffix:
Gender:F
Credentials:CCC, MS
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:NICOLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:10890 STUART CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2001
Mailing Address - Country:US
Mailing Address - Phone:720-757-6981
Mailing Address - Fax:
Practice Address - Street 1:1829 DENVER WEST DR
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3120
Practice Address - Country:US
Practice Address - Phone:303-982-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist