Provider Demographics
NPI:1982980868
Name:KHARLAMOVA, ANNA (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:KHARLAMOVA
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BECKERS LN
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-2441
Mailing Address - Country:US
Mailing Address - Phone:724-713-2639
Mailing Address - Fax:
Practice Address - Street 1:660 SOUTHPOINTE CT STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3806
Practice Address - Country:US
Practice Address - Phone:719-576-1476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COIN PROCESS231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist