Individual
ANGELA DAWN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1124 FIELD AVE, CANON CITY, CO 81212-9252
(719) 276-0991
Mailing address
1124 FIELD AVE, CANON CITY, CO 81212-9252
(719) 371-1510
(888) 375-2019
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67871879
—
CO
Enumeration date
05/11/2011
Last updated
12/28/2018
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