Provider Demographics
NPI:1992959969
Name:KAISERSHOT, MARILU B (MS, SLP-CCC)
Entity type:Individual
Prefix:MS
First Name:MARILU
Middle Name:B
Last Name:KAISERSHOT
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 N FORD ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1967
Mailing Address - Country:US
Mailing Address - Phone:210-818-9191
Mailing Address - Fax:
Practice Address - Street 1:1270 N FORD ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-1967
Practice Address - Country:US
Practice Address - Phone:210-818-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist