Provider Demographics
NPI:1679880652
Name:VANELDEREN, CATHERINE IRENE (SLPA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:IRENE
Last Name:VANELDEREN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45683 W SKY LN
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-6695
Mailing Address - Country:US
Mailing Address - Phone:480-248-4434
Mailing Address - Fax:
Practice Address - Street 1:450 N PARK RD STE 400
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6918
Practice Address - Country:US
Practice Address - Phone:954-925-3191
Practice Address - Fax:954-925-3193
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-11
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA69402355S0801X
FL1-19-39607103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant