Provider Demographics
NPI:1801080692
Name:CALLIHAN, SANDRA DENISE (MA,CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:DENISE
Last Name:CALLIHAN
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8236 CEDAR FALLS DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6635
Mailing Address - Country:US
Mailing Address - Phone:919-562-8408
Mailing Address - Fax:
Practice Address - Street 1:3001 SPRING FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2815
Practice Address - Country:US
Practice Address - Phone:919-424-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3339235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist