Provider Demographics
NPI:1316201213
Name:CALKIN, KRISTEN KIERAN
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:KIERAN
Last Name:CALKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KRISTEN
Other - Middle Name:CALKIN
Other - Last Name:OSHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 HYLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4212
Mailing Address - Country:US
Mailing Address - Phone:716-837-0320
Mailing Address - Fax:
Practice Address - Street 1:2733 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7348
Practice Address - Country:US
Practice Address - Phone:716-631-7503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1769717103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool