Provider Demographics
NPI:1932252343
Name:FENNIE, KATHLEEN P (PT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:P
Last Name:FENNIE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8671 S QUEBEC ST STE 130
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5860
Mailing Address - Country:US
Mailing Address - Phone:720-344-7034
Mailing Address - Fax:720-344-7032
Practice Address - Street 1:8671 S QUEBEC ST STE 130
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5860
Practice Address - Country:US
Practice Address - Phone:720-344-7034
Practice Address - Fax:720-344-7032
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1157174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist