Provider Demographics
NPI:1871378364
Name:CALLIHAN, ANDREA MARCELLE (MS)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARCELLE
Last Name:CALLIHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 HUNTER MILL RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:SC
Mailing Address - Zip Code:29657-9563
Mailing Address - Country:US
Mailing Address - Phone:864-245-0354
Mailing Address - Fax:
Practice Address - Street 1:1348 GRIFFIN MILL RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-8885
Practice Address - Country:US
Practice Address - Phone:864-397-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8531235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist