Provider Demographics
NPI:1790816171
Name:BERWALD, ROSEMARY RHINES (MA CCSSP SPEECH PATH)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:RHINES
Last Name:BERWALD
Suffix:
Gender:F
Credentials:MA CCSSP SPEECH PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4340 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129
Mailing Address - Country:US
Mailing Address - Phone:408-345-4949
Mailing Address - Fax:408-241-3911
Practice Address - Street 1:4340 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129
Practice Address - Country:US
Practice Address - Phone:408-345-4949
Practice Address - Fax:408-241-3911
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4153235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist