Provider Demographics
NPI:1376097014
Name:KIRK, KALIKA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KALIKA
Middle Name:
Last Name:KIRK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 S 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-4873
Mailing Address - Country:US
Mailing Address - Phone:218-766-0126
Mailing Address - Fax:
Practice Address - Street 1:7208 VAN DORN ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3651
Practice Address - Country:US
Practice Address - Phone:402-486-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8939235Z00000X
ND1502235Z00000X
NE2441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist