Provider Demographics
NPI:1679718795
Name:CALACETO, CLAUDIA L (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:L
Last Name:CALACETO
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:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:BEARSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12409-0412
Mailing Address - Country:US
Mailing Address - Phone:845-679-4655
Mailing Address - Fax:845-679-4655
Practice Address - Street 1:33 FREDERICK DR
Practice Address - Street 2:
Practice Address - City:SHADY
Practice Address - State:NY
Practice Address - Zip Code:12409-0412
Practice Address - Country:US
Practice Address - Phone:845-679-4655
Practice Address - Fax:845-679-4655
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008486-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist