Provider Demographics
NPI:1790194405
Name:KALAHER, MIEKA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:MIEKA
Middle Name:
Last Name:KALAHER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5217 OLD LITCHFIELD TRL
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-4581
Mailing Address - Country:US
Mailing Address - Phone:217-246-1887
Mailing Address - Fax:
Practice Address - Street 1:5217 OLD LITCHFIELD TRL
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-4581
Practice Address - Country:US
Practice Address - Phone:217-246-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057002676224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant