Doctor Name: | MS. ERIN MARIE ELLIS |
NPI Number: | 1619373552 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CFY-SLP |
License Number: | 242.003256 |
Business Practice Address: | 2907 Williamson County Pkwy Marion, IL - 629595256 |
Business Phone Number: | 6189989894 |
Business Fax Number: | 6189989993 |
Mailing Address: | 335 Ellis Farm Ln, HARRISBURG |
State: | IL |
Postal Code: | 629464731 |
Phone Number: | 6188418372 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2014 |
NPI Last Update Date: | 11/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 242.003256 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |