Healthcare Provider Details

I. General information

NPI: 1417727397
Provider Name (Legal Business Name): KESTRA FEIGAL CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 NORTHSTAR DR
THORNTON CO
80260-4322
US

IV. Provider business mailing address

1500 E 128TH AVE
THORNTON CO
80241-2601
US

V. Phone/Fax

Practice location:
  • Phone: 720-972-5560
  • Fax:
Mailing address:
  • Phone: 303-453-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14396089
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: