Provider Demographics
NPI:1689887275
Name:PEREZ, KATHE S (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHE
Middle Name:S
Last Name:PEREZ
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:PO BOX 271086
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-5019
Mailing Address - Country:US
Mailing Address - Phone:303-722-2181
Mailing Address - Fax:303-722-2470
Practice Address - Street 1:930 W 7TH AVE
Practice Address - Street 2:UNIT # B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4444
Practice Address - Country:US
Practice Address - Phone:303-722-2181
Practice Address - Fax:303-722-2470
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84-1369095OtherEIN