Healthcare Provider Details
I. General information
NPI: 1841378437
Provider Name (Legal Business Name): SARAH KING JESSEE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1055 CLERMONT ST
DENVER CO
80220-3808
US
IV. Provider business mailing address
127 ALBION ST
DENVER CO
80220-5612
US
V. Phone/Fax
- Phone: 303-399-8020
- Fax:
- Phone: 303-394-1757
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 472 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: