Basic Information
| Provider Information | |||||||||
| NPI: | 1073791679 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOLLENBACH | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MED CCC SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 ROCKY VALLEY ROAD | ||||||||
| Address2: | |||||||||
| City: | QUAKERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102822301 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2250 HICKORY ROAD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19462 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108341122 | ||||||||
| FaxNumber: | 6108347525 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2008 | ||||||||
| LastUpdateDate: | 02/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL003157L | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.