Kristina Nicole Calonge, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Altus, OK
NPI 1962033837 · NPPES record last updated Jan 30, 2020
Key facts
- NPI
- 1962033837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 2116 (OK)
- Practice address
- 1200 E Pecan St
Altus, OK 73521-6141 - Phone
- (580) 379-5820
- NPI assigned
- Jan 30, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2116 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2116 | OK | Yes |
Addresses
Primary practice location
1200 E Pecan St
Altus, OK 73521-6141
Mailing address
1200 E Pecan St
Altus, OK 73521-6192
Phone (580) 379-5820
Other providers in Altus, OK
- Burrows Family Clinic Aprn-CNP PLLC
- Cherity Dawn Burrows
- Elena Bustos
- Sara Calabro
- Ginny Lynn Calhoun
- Erica Camilletti
- James Robert Campbell III
- Cancer Centers of Southwest Oklahoma, LLC
- Jesse Belle Carapia Gonzalez
- Jorge Cardenas
All providers in Altus, OK · Occupational Therapy Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.