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NPI Code Detail

MEDICARE: ELLENBECKER AND BORSELLINO PLLC

MEDICARE: ELLENBECKER AND BORSELLINO PLLC
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
1261QH0700XHearing and Speech Clinic/Center
2235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215499447
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLENBECKER AND BORSELLINO PLLC
Provider Business Mailing Address
First Line : 1994 GALLATIN PIKE N STE 202
Second Line :
City : MADISON
State : TN
Zip : 37115-2024
Country : US
Telephone Number : 615-596-1830
Fax Number : 615-766-8277
Provider Business Practice Location Address
First Line : 1994 GALLATIN PIKE N STE 202
Second Line :
City : MADISON
State : TN
Zip : 37115-2024
Country : US
Telephone Number : 615-596-1830
Fax Number : 615-766-8277
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : ANGIE DAWN ELLENBECKER
Credential : MS, CCC-SLP
Telephone Number : 615-596-1830
Provider Enumeration Date : 04/05/2019
Last Update Date : 07/09/2021

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Directions to “ELLENBECKER AND BORSELLINO PLLC ” Practice Location

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