Jennifer Anne Bolten, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004907A Issued in IN

Practice address

30100 Telegraph Rd Ste 140
Bingham Farms, MI 48025

Phone

(248) 385-0030

Fax

(248) 849-9980

NPI assigned

Oct 12, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Robertson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1518292481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644",
            "fax_number": "586-541-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH RD STE 140",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "48025",
            "telephone_number": "248-385-0030",
            "fax_number": "248-849-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTEN",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004907A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ROBERTSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blair Boffman
• Kaitlyn Anne Bogdanovich
• Kristina Bojaj
• Janaya L Bolden
• Jade Bolos
• Kaitlyn Mackenzie Bolton
• Sabrina Bolvari, MA CLINICAL PSYCH.
• Anna Bommarito
• Michael Bonds, CRNA
• Carlos Daniel Bonilla Monroy

• Speech-Language Pathologist in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.