Provider Demographics
NPI:1386313880
Name:CALIX, KARLA ALEXANDRA (SLPA)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:ALEXANDRA
Last Name:CALIX
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 N 36TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3456
Mailing Address - Country:US
Mailing Address - Phone:602-244-0202
Mailing Address - Fax:
Practice Address - Street 1:4545 N 36TH ST STE 125A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3456
Practice Address - Country:US
Practice Address - Phone:602-224-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-21-184050106S00000X
AZSLPA141492355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician