Provider Demographics
NPI:1265614994
Name:BONDE, COLLEEN EGLESTON (MED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:EGLESTON
Last Name:BONDE
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2908
Mailing Address - Country:US
Mailing Address - Phone:508-359-4580
Mailing Address - Fax:
Practice Address - Street 1:198 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5025
Practice Address - Country:US
Practice Address - Phone:781-551-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist