Provider Demographics
NPI:1861845141
Name:CALLARMAN, MARY STONEHAM (SLP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:STONEHAM
Last Name:CALLARMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 VALLEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-1860
Mailing Address - Country:US
Mailing Address - Phone:214-264-8610
Mailing Address - Fax:
Practice Address - Street 1:4010 VALLEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-1860
Practice Address - Country:US
Practice Address - Phone:214-264-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist