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Individual

MARY M CALLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
190 BANGOR RD, SUITE A, ELLSWORTH, ME 04605-3258
(207) 667-7108
(207) 664-0461
Mailing address
853 NEWBURY NECK RD, SURRY, ME 04684-3710
(207) 667-1740

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ME260700
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
034994
ANTHEM
ME
01
2372663
AETNA HMO
ME
01
7714153
AETNA NON-HMO
ME
Enumeration date
01/24/2007
Last updated
07/09/2007
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