Provider Demographics
NPI:1306091632
Name:CALKINS, KATIE L (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:L
Last Name:CALKINS
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 1:185 MARGARET STREET
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901
Mailing Address - Country:US
Mailing Address - Phone:518-561-6361
Mailing Address - Fax:518-561-6367
Practice Address - Street 1:185 MARGARET ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1837
Practice Address - Country:US
Practice Address - Phone:518-561-6361
Practice Address - Fax:518-561-6367
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist