Provider Demographics
NPI:1083131437
Name:CAROLINA, CALLA CASHAI
Entity Type:Individual
Prefix:
First Name:CALLA
Middle Name:CASHAI
Last Name:CAROLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 W WOOD ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-4705
Mailing Address - Country:US
Mailing Address - Phone:405-712-9141
Mailing Address - Fax:
Practice Address - Street 1:712 W WOOD ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-4705
Practice Address - Country:US
Practice Address - Phone:405-712-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator