Provider Demographics
NPI:1366970642
Name:CALHOUN, ALICIA LAUREN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:LAUREN
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60017 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38870-8001
Mailing Address - Country:US
Mailing Address - Phone:662-315-1160
Mailing Address - Fax:
Practice Address - Street 1:1215 EARL FRYE BLVD
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821
Practice Address - Country:US
Practice Address - Phone:662-256-9344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist