Doctor Name: | MRS. MADELINE CLARE ELLIS |
NPI Number: | 1144644154 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | SP. 11313 |
Business Practice Address: | 269 Portland Way S Galion, OH - 448332312 |
Business Phone Number: | 4194680547 |
Business Fax Number: | |
Mailing Address: | 319 Castor Rd, Apt 103 LEXINGTON |
State: | OH |
Postal Code: | 449048758 |
Phone Number: | 4196100000 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2014 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP. 11313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |