Provider Demographics
NPI:1184455669
Name:KEELING, KAITLYN RENEE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:RENEE
Last Name:KEELING
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 40TH ST UNIT 1039
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5479
Mailing Address - Country:US
Mailing Address - Phone:417-499-4639
Mailing Address - Fax:
Practice Address - Street 1:1350 40TH ST UNIT 1039
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5479
Practice Address - Country:US
Practice Address - Phone:417-499-4639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24465854235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist