Provider Demographics
NPI:1114159662
Name:CALMAC, VALENTINA DELI (OTRL, CHT)
Entity Type:Individual
Prefix:
First Name:VALENTINA
Middle Name:DELI
Last Name:CALMAC
Suffix:
Gender:F
Credentials:OTRL, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5798 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1826
Mailing Address - Country:US
Mailing Address - Phone:248-724-4400
Mailing Address - Fax:248-724-4405
Practice Address - Street 1:1282 KIRTS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4890
Practice Address - Country:US
Practice Address - Phone:248-918-5560
Practice Address - Fax:248-918-5565
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007602225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN69750060Medicare PIN
MIMI6211014Medicare PIN