Provider Demographics
NPI:1073327656
Name:ROUSE, KALIA MARIE
Entity type:Individual
Prefix:
First Name:KALIA
Middle Name:MARIE
Last Name:ROUSE
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 1:6312 HIGHWAY 41A STE 104B
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-8221
Mailing Address - Country:US
Mailing Address - Phone:615-934-5756
Mailing Address - Fax:
Practice Address - Street 1:6312 HIGHWAY 41A STE 104B
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-8221
Practice Address - Country:US
Practice Address - Phone:615-934-5756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9253225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist