Healthcare Provider Details

I. General information

NPI: 1437678745
Provider Name (Legal Business Name): LYNSEY KATHERINE KOLO MSP, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNSEY KATHERINE KOLO MSP, CCC-SLP

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 N LINCOLN ST
DENVER CO
80203-2996
US

IV. Provider business mailing address

1860 N LINCOLN ST
DENVER CO
80203-7300
US

V. Phone/Fax

Practice location:
  • Phone: 720-423-3200
  • Fax:
Mailing address:
  • Phone: 720-423-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number24495363
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number412290
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP7747
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: