Provider Demographics
NPI:1003970286
Name:KALARCHIK, SUSAN LEIGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LEIGH
Last Name:KALARCHIK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 #4 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-0800
Mailing Address - Country:US
Mailing Address - Phone:406-494-3995
Mailing Address - Fax:406-494-3373
Practice Address - Street 1:3310 MONROE AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-3820
Practice Address - Country:US
Practice Address - Phone:406-494-3995
Practice Address - Fax:406-494-3373
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT825231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT530283Medicaid