Provider Demographics
NPI:1124203930
Name:ALDEN, JUDITH ANN (MS W/ CCC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:ALDEN
Suffix:
Gender:F
Credentials:MS W/ CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MO
Mailing Address - Zip Code:64644-0128
Mailing Address - Country:US
Mailing Address - Phone:816-583-2134
Mailing Address - Fax:816-583-2004
Practice Address - Street 1:HIGHWAY 13 SOUTH
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MO
Practice Address - Zip Code:64644-0128
Practice Address - Country:US
Practice Address - Phone:816-583-2134
Practice Address - Fax:816-583-2004
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist