Provider Demographics
NPI:1467843870
Name:D'HAENE, KALI (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:D'HAENE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7772 BAY CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5324
Mailing Address - Country:US
Mailing Address - Phone:517-294-8699
Mailing Address - Fax:
Practice Address - Street 1:5728 MAJOR BLVD STE 600
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7970
Practice Address - Country:US
Practice Address - Phone:407-280-3776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14660235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ 7011OtherFLORIDA LICENSE