Provider Demographics
NPI:1841017993
Name:CALLEN, SCARLETT A (LMT)
Entity type:Individual
Prefix:MRS
First Name:SCARLETT
Middle Name:A
Last Name:CALLEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 JUDGE ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY
Mailing Address - State:AR
Mailing Address - Zip Code:72469-8034
Mailing Address - Country:US
Mailing Address - Phone:870-384-0813
Mailing Address - Fax:
Practice Address - Street 1:116A NORTH ST
Practice Address - Street 2:
Practice Address - City:CAVE CITY
Practice Address - State:AR
Practice Address - Zip Code:72521-9019
Practice Address - Country:US
Practice Address - Phone:870-384-0813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8728225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist