Provider Demographics
NPI:1972879468
Name:KILKER, CALLI-JO (COTA)
Entity Type:Individual
Prefix:
First Name:CALLI-JO
Middle Name:
Last Name:KILKER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8816 N WARE RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9626
Mailing Address - Country:US
Mailing Address - Phone:361-903-9112
Mailing Address - Fax:
Practice Address - Street 1:844 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560-4178
Practice Address - Country:US
Practice Address - Phone:956-584-8100
Practice Address - Fax:956-584-8149
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211525224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant