Provider Demographics
NPI:1225575905
Name:HADIN, KALI
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:HADIN
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 1:25190 STATE HIGHWAY 25
Mailing Address - Street 2:
Mailing Address - City:HOLCOMB
Mailing Address - State:MO
Mailing Address - Zip Code:63852-7177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25190 STATE HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:HOLCOMB
Practice Address - State:MO
Practice Address - Zip Code:63852-7177
Practice Address - Country:US
Practice Address - Phone:573-719-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator