Provider Demographics
NPI:1609004274
Name:KALSTEK, GAIL ELIZABETH (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ELIZABETH
Last Name:KALSTEK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:GAIL
Other - Middle Name:ELIZABETH
Other - Last Name:SCRIVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:135 CLODFELTER RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-7810
Mailing Address - Country:US
Mailing Address - Phone:704-660-6765
Mailing Address - Fax:704-660-6765
Practice Address - Street 1:710 JULIAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9079
Practice Address - Country:US
Practice Address - Phone:704-636-5812
Practice Address - Fax:704-636-8464
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3064224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant