Provider Demographics
NPI:1922554310
Name:O'CALLAGHAN, JUSTINE
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:O'CALLAGHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8733 HOLLY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-9194
Mailing Address - Country:US
Mailing Address - Phone:919-981-6588
Mailing Address - Fax:919-386-4967
Practice Address - Street 1:8733 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-9194
Practice Address - Country:US
Practice Address - Phone:919-981-6588
Practice Address - Fax:919-386-4967
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30001938235Z00000X
CA22824235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist