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General NPI Number Information
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NPI Number | 1487442109
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Entity Type | Individual
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Provider Name | RICKY CALLAHAN
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Gender | Male
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 7420 NW 5TH ST STE 110
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City | PLANTATION
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State | FL
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Zip | 33317-1611
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Country | US
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Telephone | 954-321-3595
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Fax |
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Provider Business Mailing Address
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Address Line | 19730 NW 11TH CT
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City | MIAMI
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State | FL
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Zip | 33169-3006
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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