Individual
JENNIFER P VAN GILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC, SLP
Contact information
Practice address
400 UNIVERSITY HALL DRIVE, ROOM 120, BOONE, NC 28608-2041
(828) 262-2185
(828) 262-6766
Mailing address
400 UNIVERSITY HALL DRIVE, ROOM 120, BOONE, NC 28608-2041
(828) 262-2185
(828) 262-6766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13477
BLUE CROSS BS OF NC
NC
05
—
7411363
—
NC
Enumeration date
07/23/2006
Last updated
05/16/2023
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