Provider Demographics
NPI:1871768416
Name:GARDZELEWSKI, KIRSTEN ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:ANN
Last Name:GARDZELEWSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 W GLENNON DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2572
Mailing Address - Country:US
Mailing Address - Phone:303-716-2915
Mailing Address - Fax:
Practice Address - Street 1:11390 W GLENNON DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2572
Practice Address - Country:US
Practice Address - Phone:303-716-2915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist