Provider Demographics
NPI:1679927156
Name:DEPALMA, KAI
Entity type:Individual
Prefix:MS
First Name:KAI
Middle Name:
Last Name:DEPALMA
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAI
Other - Middle Name:
Other - Last Name:DEPALMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:16 VIRGINIA DR
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-9434
Mailing Address - Country:US
Mailing Address - Phone:413-478-3956
Mailing Address - Fax:
Practice Address - Street 1:16 VIRGINIA DR
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:MA
Practice Address - Zip Code:01033-9434
Practice Address - Country:US
Practice Address - Phone:413-478-3956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005086235Z00000X
MA8869235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist