| Doctor Name: | CAROL SUE BOSCH |
| NPI Number: | 1205168648 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | 15402 |
| Business Practice Address: | 4212 N Pershing Ave #a1 Stockton, CA - 952076952 |
| Business Phone Number: | 2099573900 |
| Business Fax Number: | 2096729440 |
| Mailing Address: | 924 Twin Oaks Dr, TRACY |
| State: | CA |
| Postal Code: | 953778749 |
| Phone Number: | 2098307049 |
| Fax Number: | 2098307049 |
| NPI Enumeration Date: | 02/10/2010 |
| NPI Last Update Date: | 02/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 15402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |