Healthcare Provider Details

I. General information

NPI: 1144151325
Provider Name (Legal Business Name): STEPHANIE CALDERON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 4TH AVE SW
HICKORY NC
28602-2805
US

IV. Provider business mailing address

809 4TH ST NE
CONOVER NC
28613-1802
US

V. Phone/Fax

Practice location:
  • Phone: 828-324-8884
  • Fax:
Mailing address:
  • Phone: 828-638-2405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5061
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: