Provider Demographics
NPI:1881835643
Name:ALDEN, CAROL LEE (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LEE
Last Name:ALDEN
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:LEE
Other - Last Name:ALDEN-WEINBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:111 WHITELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3538
Mailing Address - Country:US
Mailing Address - Phone:617-696-3396
Mailing Address - Fax:617-696-3396
Practice Address - Street 1:484 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1893
Practice Address - Country:US
Practice Address - Phone:508-757-2756
Practice Address - Fax:508-831-9768
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist