Provider Demographics
NPI:1316480015
Name:KRAEMER, AMANDA MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:KRAEMER
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 1:1310 N FRANKLIN ST APT 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2438
Mailing Address - Country:US
Mailing Address - Phone:813-494-3302
Mailing Address - Fax:
Practice Address - Street 1:6000 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5721
Practice Address - Country:US
Practice Address - Phone:303-757-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0002537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist