Provider Demographics
NPI:1255695458
Name:BARTHOLOMEW, CAROL I (MSCCCSLP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:I
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2746
Mailing Address - Country:US
Mailing Address - Phone:570-654-3088
Mailing Address - Fax:
Practice Address - Street 1:523 SECOND ST
Practice Address - Street 2:
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643-2746
Practice Address - Country:US
Practice Address - Phone:570-654-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000337L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist