Provider Demographics
NPI:1194339333
Name:ALLEY, KALI (OTR/L)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:
Last Name:ALLEY
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 STATE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1914
Mailing Address - Country:US
Mailing Address - Phone:207-460-4777
Mailing Address - Fax:
Practice Address - Street 1:28 GILMAN PLZ
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3561
Practice Address - Country:US
Practice Address - Phone:207-990-0162
Practice Address - Fax:207-255-8748
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MEOT4705225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor