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General NPI Number Information
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NPI Number | 1679880652
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Entity Type | Individual
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Provider Name | CATHERINE IRENE VANELDEREN SLPA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2010
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 450 N PARK RD STE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6918
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Country | US
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Telephone | 954-925-3191
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Fax | 954-925-3193
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Provider Business Mailing Address
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Address Line | 45683 W SKY LN
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City | MARICOPA
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State | AZ
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Zip | 85139-6695
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Country | US
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Telephone | 480-248-4434
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA6940
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-19-39607
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License Number State | FL
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