Provider Demographics
NPI:1609588318
Name:CALDER, CAROLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:CALDER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16909 DAWN FLOWER CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-4081
Mailing Address - Country:US
Mailing Address - Phone:512-497-2280
Mailing Address - Fax:
Practice Address - Street 1:11801 SONOMA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5408
Practice Address - Country:US
Practice Address - Phone:512-533-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist