MEDICARE: LARISA KALINOWSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1053094060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARISA KALINOWSKI

Provider Business Mailing Address
First Line	:	46-050 KONANE PL APT 3721
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-6123
Country	:	US
Telephone Number	:	216-470-8692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1490 QUARTERPATH RD STE 5A
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23185-6544
Country	:	US
Telephone Number	:	757-206-2805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	06/09/2026

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Directions to “ LARISA KALINOWSKI ” Practice Location

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