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General NPI Number Information
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NPI Number | 1306488457
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Entity Type | Individual
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Provider Name | ABBIE JORDAN ELPHICK
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Gender | Female
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 401 E ILLINOIS AVE
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City | MIDLAND
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State | TX
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Zip | 79701-4803
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Country | US
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Telephone | 432-570-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 3209 CIMMARON AVE
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City | MIDLAND
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State | TX
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Zip | 79705-6210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 114694
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License Number State | TX
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