Provider Demographics
NPI:1528103405
Name:CALI, KIMBERLY (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:CALI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1080 ARTEMIS CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026
Mailing Address - Country:US
Mailing Address - Phone:720-470-7362
Mailing Address - Fax:
Practice Address - Street 1:1080 ARTEMIS CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:720-470-7362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0312634235Z00000X
COSLP.0000351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO35308869Medicaid
CO95121234Medicaid