Provider Demographics
NPI:1568010361
Name:CALLAHAN, CATHERINE SUZANNE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:SUZANNE
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6168 BENTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2615
Mailing Address - Country:US
Mailing Address - Phone:817-479-7019
Mailing Address - Fax:
Practice Address - Street 1:6168 BENTRIDGE DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2615
Practice Address - Country:US
Practice Address - Phone:817-479-7019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist