| Organization Name: | ELLEN EDWARDS, PLLC |
| NPI Number: | 1619076601 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLEN EDWARDS (DIRECTOR) |
| Mailing Address: | 626 Grant St Ste K Herndon |
| State: | VA US |
| Postal Code: | 201704700 |
| Phone Number: | 7039048334 |
| Fax Number: | 7039048334 |
| NPI Enumeration Date: | 09/22/2006 |
| NPI Last Update Date: | 06/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202002947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |