Provider Demographics
NPI:1164005450
Name:CALKINS, KALI NICOLE
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:NICOLE
Last Name:CALKINS
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 1:484 ALBERTSON PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-4968
Mailing Address - Country:US
Mailing Address - Phone:337-839-8883
Mailing Address - Fax:337-839-8939
Practice Address - Street 1:1700 KALISTE SALOOM RD STE 300
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6187
Practice Address - Country:US
Practice Address - Phone:337-269-1161
Practice Address - Fax:337-269-1169
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA326012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist