Provider Demographics
NPI:1396071320
Name:WILLINGHAM, CALI VAUGHN (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:CALI
Middle Name:VAUGHN
Last Name:WILLINGHAM
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:RED OAK ELEMENTARY SPEECH PATHOLOGIST
Mailing Address - Street 2:200 VALLEY RIDGE DR.
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154
Mailing Address - Country:US
Mailing Address - Phone:972-617-3523
Mailing Address - Fax:
Practice Address - Street 1:RED OAK INDEPENDENT SCHOOL DISTRICT
Practice Address - Street 2:109 W RED OAK RD
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-6335
Practice Address - Country:US
Practice Address - Phone:972-617-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist