Provider Demographics
NPI:1093149973
Name:CALABRIA, KELLIANN (SLP-CFY)
Entity Type:Individual
Prefix:MS
First Name:KELLIANN
Middle Name:
Last Name:CALABRIA
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5633 S STAPLES ST STE 500
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4646
Mailing Address - Country:US
Mailing Address - Phone:361-855-1352
Mailing Address - Fax:
Practice Address - Street 1:5633 S STAPLES ST STE 500
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4646
Practice Address - Country:US
Practice Address - Phone:361-855-1352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist