Provider Demographics
NPI:1790503266
Name:HARRIS, KELSEY (AUD)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5900 SOUTHRIDGE GREENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-9472
Mailing Address - Country:US
Mailing Address - Phone:970-294-5577
Mailing Address - Fax:
Practice Address - Street 1:4703 BOARDWALK DR UNIT B2
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3766
Practice Address - Country:US
Practice Address - Phone:970-682-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1292231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist