Provider Demographics
NPI:1063745255
Name:BIDDLE, KYLEE MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:MARIE
Last Name:BIDDLE
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 1:610 LOGAN ST APT 9
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3639
Mailing Address - Country:US
Mailing Address - Phone:435-776-7246
Mailing Address - Fax:
Practice Address - Street 1:610 LOGAN ST APT 9
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3639
Practice Address - Country:US
Practice Address - Phone:513-461-9341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-07
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12076834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist