Provider Demographics
NPI:1801551155
Name:ESTES, CALLIE S (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:S
Last Name:ESTES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-1744
Mailing Address - Country:US
Mailing Address - Phone:256-431-6202
Mailing Address - Fax:
Practice Address - Street 1:208 N MADISON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-1744
Practice Address - Country:US
Practice Address - Phone:256-431-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist