Provider Demographics
NPI:1710684022
Name:VALDEZ, KHRISI MARIE (OROFACIAL MYOLOGIST)
Entity Type:Individual
Prefix:
First Name:KHRISI
Middle Name:MARIE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:OROFACIAL MYOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2549
Mailing Address - Country:US
Mailing Address - Phone:303-759-2760
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2549
Practice Address - Country:US
Practice Address - Phone:303-759-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1245788225500000X
CO124577235500000X, 246Z00000X
CO124578235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other