Doctor Name: | JENNIFER RUTH ELTON |
NPI Number: | 1205892577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 12017360 |
Business Practice Address: | 439 Carol Ln Shoreview, MN - 551264705 |
Business Phone Number: | 6123086132 |
Business Fax Number: | 6514149339 |
Mailing Address: | Po Box 11, CIRCLE PINES |
State: | MN |
Postal Code: | 550140011 |
Phone Number: | 6123086132 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2006 |
NPI Last Update Date: | 11/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12017360 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |