Provider Demographics
NPI:1760981674
Name:KRIKORIAN, SHANNON RACHEL (MS)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:RACHEL
Last Name:KRIKORIAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9190 E NASSAU AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1919
Mailing Address - Country:US
Mailing Address - Phone:214-284-9290
Mailing Address - Fax:
Practice Address - Street 1:10200 PIEDMONT DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5500
Practice Address - Country:US
Practice Address - Phone:303-387-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist