Healthcare Provider Details

I. General information

NPI: 1578490884
Provider Name (Legal Business Name): KAITLYN BUCHTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E CHERRY CREEK SOUTH DR STE 710
DENVER CO
80246-1534
US

IV. Provider business mailing address

3724 BONITA DR
PLANO TX
75025-4339
US

V. Phone/Fax

Practice location:
  • Phone: 972-251-0602
  • Fax:
Mailing address:
  • Phone: 972-251-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0004572
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: