Provider Demographics
NPI:1205210937
Name:MCCALLUM, CINDY (MS)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MCCALLUM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15864 W 67TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7006
Mailing Address - Country:US
Mailing Address - Phone:303-927-9952
Mailing Address - Fax:
Practice Address - Street 1:15864 W 67TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7006
Practice Address - Country:US
Practice Address - Phone:303-927-9952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0001666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14090390OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION CERTIFICATION
COSLP.0001666OtherDEPARTMENT OF REGULATORY AFFAIRS