Individual
MARY CAROL CALAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC S-LP
Contact information
Practice address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
Mailing address
416 S 13TH ST, COEUR D ALENE, ID 83814-3917
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1150
ID
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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