Provider Demographics
NPI:1538477179
Name:BONE, CARINA WULF (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CARINA
Middle Name:WULF
Last Name:BONE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 E ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1337
Mailing Address - Country:US
Mailing Address - Phone:315-685-8361
Mailing Address - Fax:315-685-0347
Practice Address - Street 1:49 E ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-1337
Practice Address - Country:US
Practice Address - Phone:315-685-8361
Practice Address - Fax:315-685-0347
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003360-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist