Provider Demographics
NPI:1134561517
Name:CALDERON, SUGEY ADELA (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SUGEY
Middle Name:ADELA
Last Name:CALDERON
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 1:1100 WYTHE ST UNIT 25382
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22313-8076
Mailing Address - Country:US
Mailing Address - Phone:202-386-1974
Mailing Address - Fax:
Practice Address - Street 1:3101 N HAMPTON DR APT 712
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1524
Practice Address - Country:US
Practice Address - Phone:202-241-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08284235Z00000X
DCSLP000845235Z00000X
TX109172235Z00000X
235Z00000X
VA2202008746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist