Healthcare Provider Details

I. General information

NPI: 1073252920
Provider Name (Legal Business Name): MOLLY KULENDRAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2672 SIERRA SPRINGS DR
COLORADO SPRINGS CO
80916-2448
US

IV. Provider business mailing address

2672 SIERRA SPRINGS DR
COLORADO SPRINGS CO
80916-2448
US

V. Phone/Fax

Practice location:
  • Phone: 913-708-5439
  • Fax:
Mailing address:
  • Phone: 913-708-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14393410
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4906
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: