Provider Demographics
NPI:1992548135
Name:SCHALLER, KASI
Entity type:Individual
Prefix:
First Name:KASI
Middle Name:
Last Name:SCHALLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 BROOKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6035 BROOKSHIRE DR
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:IN
Practice Address - Zip Code:46167-9305
Practice Address - Country:US
Practice Address - Phone:317-619-3887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006428A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist