Provider Demographics
NPI:1497917884
Name:CALLINAN, RENEE M (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:CALLINAN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:299 FAUNCE CORNER ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:20747
Practice Address - Country:US
Practice Address - Phone:508-995-0700
Practice Address - Fax:508-973-1355
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA456231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist