Provider Demographics
NPI:1356655716
Name:CALDWELL, MARY APPLETON (MA, ED, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:APPLETON
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MA, ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5654 BUCKHORN RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-9627
Mailing Address - Country:US
Mailing Address - Phone:336-577-3346
Mailing Address - Fax:
Practice Address - Street 1:5654 BUCKHORN RD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-9627
Practice Address - Country:US
Practice Address - Phone:336-577-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2076235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist