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General NPI Number Information
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NPI Number | 1124429634
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Entity Type | Individual
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Provider Name | SELENA CALLAGHAN MS,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1694 W BROAD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2108
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Country | US
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Telephone | 931-263-8908
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Fax |
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Provider Business Mailing Address
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Address Line | 68 ROLAND ST
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City | CROSSVILLE
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State | TN
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Zip | 38555-5430
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Country | US
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Telephone | 615-626-1058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4559
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License Number State | TN
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