Provider Demographics
NPI:1245787357
Name:CALLINO, RACHEL LAUREN (MS, CCC-SLP, QOM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAUREN
Last Name:CALLINO
Suffix:
Gender:F
Credentials:MS, CCC-SLP, QOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 AVE AT PORT IMPERIAL BLVD APT 1034
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-6113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 AVE AT PORT IMPERIAL BLVD APT 1034
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-6113
Practice Address - Country:US
Practice Address - Phone:781-413-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist