Provider Demographics
NPI:1548402779
Name:BAKER, KATHY CALHOUN (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:CALHOUN
Last Name:BAKER
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 OLD PLANTATION DR W
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1005
Mailing Address - Country:US
Mailing Address - Phone:843-982-0996
Mailing Address - Fax:843-982-0996
Practice Address - Street 1:209 OLD PLANTATION DR W
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1005
Practice Address - Country:US
Practice Address - Phone:843-982-0996
Practice Address - Fax:843-982-0996
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist