Provider Demographics
NPI:1912169293
Name:KARLIK, CARRIE BETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:BETH
Last Name:KARLIK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:BETH
Other - Last Name:FERTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:8155 E. FAIRMOUNT DRIVE
Mailing Address - Street 2:#435
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230
Mailing Address - Country:US
Mailing Address - Phone:719-213-3804
Mailing Address - Fax:
Practice Address - Street 1:8155 E. FAIRMOUNT DRIVE
Practice Address - Street 2:#435
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230
Practice Address - Country:US
Practice Address - Phone:719-213-3804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09651331Medicaid