Individual
MRS. KAREN MALOTT GACNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-A
Contact information
Practice address
712 FORTINO BLVD, STE. D, PUEBLO, CO 81008-2084
(719) 542-1760
(179) 542-5115
Mailing address
712 FORTINO BLVD, STE. D, PUEBLO, CO 81008-2084
(719) 542-1760
(179) 542-5115
Taxonomy
Speciality
Code
Description
License number
State
231HA2400X
Assistive Technology Practitioner Audiologist
Primary
471
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00200291
RR MEDICARE
—
Enumeration date
03/19/2007
Last updated
01/07/2008
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