Individual
MISS JENNIFER VANDENBERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.L.P.
Contact information
Practice address
7401 OSLER DR, SUITE 110, TOWSON, MD 21204-7673
(410) 296-8888
Mailing address
7063 SADDLE DR, SYKESVILLE, MD 21784-5936
(410) 549-5501
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
03549
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
621764
BC BS
MD
Enumeration date
02/13/2007
Last updated
07/08/2007
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