Provider Demographics
NPI:1679822696
Name:WOLKING, CALLIE NICOLE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CALLIE
Middle Name:NICOLE
Last Name:WOLKING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:NICOLE
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:814 DELLA VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-8704
Mailing Address - Country:US
Mailing Address - Phone:719-269-6865
Mailing Address - Fax:
Practice Address - Street 1:490 N DIAMOND AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2521
Practice Address - Country:US
Practice Address - Phone:719-276-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist