Provider Demographics
NPI:1306246707
Name:VANCE, KRISTY
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:VANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9968 NADINE LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9529
Mailing Address - Country:US
Mailing Address - Phone:303-506-9904
Mailing Address - Fax:
Practice Address - Street 1:9224 TEDDY LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6798
Practice Address - Country:US
Practice Address - Phone:303-506-9904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2017-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker