Provider Demographics
NPI:1962273565
Name:COLE, KALLI A (MS, CF- SLP)
Entity type:Individual
Prefix:
First Name:KALLI
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:MS, CF- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MS
Mailing Address - Zip Code:39740-1008
Mailing Address - Country:US
Mailing Address - Phone:910-578-1958
Mailing Address - Fax:
Practice Address - Street 1:1411 HIGHWAY 389
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-8451
Practice Address - Country:US
Practice Address - Phone:662-769-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist