Basic Information
Provider Information
NPI: 1942923867
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CALKA
FirstName: DAYNA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: AKERS
OtherFirstName: DAYNA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 5095 JUNE DR
Address2:  
City: ALMONT
State: MI
PostalCode: 480038767
CountryCode: US
TelephoneNumber: 2486869478
FaxNumber:  
Practice Location
Address1: 2399 E WALTON BLVD
Address2:  
City: AUBURN HILLS
State: MI
PostalCode: 483261955
CountryCode: US
TelephoneNumber: 2484756300
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2022
LastUpdateDate: 10/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X6451022456MIY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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