Provider Demographics
NPI:1982496857
Name:DAIGLE, KALASIA ROSE
Entity type:Individual
Prefix:
First Name:KALASIA
Middle Name:ROSE
Last Name:DAIGLE
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 1:575 SHERMAN FARM RD
Mailing Address - Street 2:
Mailing Address - City:BURRILLVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830-1152
Mailing Address - Country:US
Mailing Address - Phone:401-331-7850
Mailing Address - Fax:
Practice Address - Street 1:891 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4020
Practice Address - Country:US
Practice Address - Phone:401-331-7850
Practice Address - Fax:401-274-4739
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program