Provider Demographics
NPI:1649704099
Name:KALINA, CARRIE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:KALINA
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 WAKEFIELD RUN BLVD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:272 WAKEFIELD RUN BLVD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233
Practice Address - Country:US
Practice Address - Phone:330-461-5489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 5183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist