Provider Demographics
NPI:1912875618
Name:CALABRESE, AVA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:CALABRESE
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 1:331 TEQUESTA DR APT 113
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-3035
Mailing Address - Country:US
Mailing Address - Phone:203-592-3024
Mailing Address - Fax:
Practice Address - Street 1:935 MILITARY TRL STE 102
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7009
Practice Address - Country:US
Practice Address - Phone:561-748-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-25
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA23602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty