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Individual

MRS. ELIZABETH M CALLANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC SLP

Contact information

Practice address
625 N UNION ST, KOKOMO, IN 46901-2907
(765) 454-9748
(765) 450-6664
Mailing address
700 E. FIRMIN STREET, SUITE 209, KOKOMO, IN 46902-2375
(765) 454-9748
(765) 450-6664

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004012A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000375489
ANTHEM
IN
05
200533240
IN
05
200533270
IN
05
200533270A
IN
Enumeration date
02/22/2007
Last updated
12/09/2014
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