Provider Demographics
NPI:1033414537
Name:CALLERY, KARI (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:
Last Name:CALLERY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 MERRIDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5263
Mailing Address - Country:US
Mailing Address - Phone:301-829-2975
Mailing Address - Fax:
Practice Address - Street 1:1300 W OLD LIBERTY RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9329
Practice Address - Country:US
Practice Address - Phone:410-751-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD06124OtherMARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE
MD12157099OtherASHA