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Individual

MARY KATHRYN THURSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,CCC/SLP

Contact information

Practice address
175 S UNION BLVD, SUITE 255, COLORADO SPRINGS, CO 80910-3113
(719) 365-5000
Mailing address
175 S UNION BLVD, SUITE 255, COLORADO SPRINGS, CO 80910-3113
(719) 365-5000

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000880
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000880
STATE LICENSE
CO
Enumeration date
09/20/2012
Last updated
09/26/2015
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