Provider Demographics
NPI:1508691809
Name:CALLEGARI, JAYDE MICHELLE
Entity type:Individual
Prefix:
First Name:JAYDE
Middle Name:MICHELLE
Last Name:CALLEGARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2406
Mailing Address - Country:US
Mailing Address - Phone:318-597-5180
Mailing Address - Fax:318-598-5111
Practice Address - Street 1:114 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-2406
Practice Address - Country:US
Practice Address - Phone:319-597-5180
Practice Address - Fax:318-597-5111
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator