Provider Demographics
NPI:1538427935
Name:KRUMMENACKER, COLLEEN (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:
Last Name:KRUMMENACKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 W 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4105
Mailing Address - Country:US
Mailing Address - Phone:607-206-0412
Mailing Address - Fax:
Practice Address - Street 1:2921 W 28TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4105
Practice Address - Country:US
Practice Address - Phone:607-206-0412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021843235Z00000X
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist