Provider Demographics
NPI:1689994519
Name:KALIES, LEILANI MARIA (MPH, OT/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:LEILANI
Middle Name:MARIA
Last Name:KALIES
Suffix:
Gender:F
Credentials:MPH, OT/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 N SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-7538
Mailing Address - Country:US
Mailing Address - Phone:405-272-5450
Mailing Address - Fax:405-848-2309
Practice Address - Street 1:6201 N SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-7538
Practice Address - Country:US
Practice Address - Phone:405-272-5450
Practice Address - Fax:405-848-2309
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT 421225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand