Provider Demographics
NPI:1598004129
Name:ST PIERRE, SUE KALCHIK (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:KALCHIK
Last Name:ST PIERRE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:ELANA SUE
Other - Middle Name:KALCHIK
Other - Last Name:STPIERRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:700 CALLE DE LEON
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7308
Mailing Address - Country:US
Mailing Address - Phone:505-984-0249
Mailing Address - Fax:
Practice Address - Street 1:700 CALLE DE LEON
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7308
Practice Address - Country:US
Practice Address - Phone:505-984-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM611225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics