Caroline Renee Callaway, MT-BC
Psychologist, Clinical in Southfield, MI. Individual provider (NPI-1).
NPI number1265950752
StatusActive
Last updated in NPPESDec 4, 2020
Details
- NPI
- 1265950752
- Entity type
- Individual (NPI-1)
- Name
- Caroline Renee Callaway
- Credential
- MT-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2017
- Certification date
- Dec 4, 2020
- Last updated
- Dec 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6352000248 | MI | Yes |
| 225A00000X | Music Therapist | – | OR |
Practice location
20411 W 12 Mile Rd Ste 101Southfield, MI 48076-6404
Phone 866-703-1901
Mailing address
20411 W 12 Mile Rd Ste 101Southfield, MI 48076-6404
Phone 866-703-1901
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