Doctor Name: | MRS. ELAINE THERESA DESILVA-ELICH |
NPI Number: | 1073896817 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-LIC |
License Number: | 005576-1 |
Business Practice Address: | 88 Kirkland Rd Rochester, NY - 146113137 |
Business Phone Number: | 5853288228 |
Business Fax Number: | 5859357429 |
Mailing Address: | 88 Kirkland Road, Adlai E Stevenson School No 29 ROCHESTER |
State: | NY |
Postal Code: | 14611 |
Phone Number: | 5853288228 |
Fax Number: | 5859357429 |
NPI Enumeration Date: | 09/27/2011 |
NPI Last Update Date: | 09/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 005576-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |