Provider Demographics
NPI:1891469813
Name:CALDWELL, REAGAN (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:REAGAN
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39670 HIGHWAY 32
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:MO
Mailing Address - Zip Code:65543-9102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2028
Practice Address - Country:US
Practice Address - Phone:417-257-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist