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NPI Code Detail

MEDICARE: DR. ALICIA A. ELLIOTT SPEECH PATHOLOGY, INC.

MEDICARE: DR. ALICIA A. ELLIOTT SPEECH PATHOLOGY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4207CA

General Provider Information

NPI Number : 1144508599
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. ALICIA A. ELLIOTT SPEECH PATHOLOGY, INC.
Provider Business Mailing Address
First Line : 2506 FOOTHILL BLVD
Second Line :
City : LA CRESCENTA
State : CA
Zip : 91214-3506
Country : US
Telephone Number : 818-236-3603
Fax Number : 818-236-2106
Provider Business Practice Location Address
First Line : 2506 FOOTHILL BLVD
Second Line :
City : LA CRESCENTA
State : CA
Zip : 91214-3506
Country : US
Telephone Number : 818-236-3603
Fax Number : 818-236-2106
Authorized Official
Title or Position : DIRECTOR/SPEECH PATHOLOGIST
Name : DR. ALICIA A. ELLIOTT
Credential : ED.D
Telephone Number : 818-236-3603
Provider Enumeration Date : 08/02/2011
Last Update Date : 08/02/2011

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Directions to “DR. ALICIA A. ELLIOTT SPEECH PATHOLOGY, INC. ” Practice Location

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