Provider Demographics
NPI:1720377310
Name:VANDENBOSCH, CAROLYNN GENE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYNN
Middle Name:GENE
Last Name:VANDENBOSCH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2399 E WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-1955
Mailing Address - Country:US
Mailing Address - Phone:248-475-6400
Mailing Address - Fax:248-475-6403
Practice Address - Street 1:2399 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1955
Practice Address - Country:US
Practice Address - Phone:248-475-6400
Practice Address - Fax:248-475-6403
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist