Individual
ELLECIA DECOUTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SE INTERNATIONAL WAY, STE 100, MILWAUKIE, OR 97222-4628
(971) 206-5205
Mailing address
1453 FOUR SEASONS DR, ROSEBURG, OR 97470-3521
(971) 219-4857
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15632
OR
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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