Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XF0002X | Feeding, Eating & Swallowing | 006665-1 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 006665-1 | NY |
NPI | 1083866693 |
---|---|
Provider Name | Melissa Marie Callahan |
First Address | Philadelphia, PA 19123-2347 |
Second Address | Philadelphia, PA 19123-2347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2008 |
Last Update Date | 24/01/2021 |