Provider Demographics
NPI:1215194915
Name:CALLAHAN, MARK LAWRENCE (SLP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:LAWRENCE
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 BABCOCK BLVD
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2564
Mailing Address - Country:US
Mailing Address - Phone:412-369-5150
Mailing Address - Fax:412-369-5163
Practice Address - Street 1:6000 BABCOCK BLVD
Practice Address - Street 2:SUITE 1002
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2564
Practice Address - Country:US
Practice Address - Phone:412-369-5150
Practice Address - Fax:412-369-5163
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003238L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist