Individual
ELLEN DISALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
404 N MADISON ST, QUINCY, FL 32351-1825
(850) 556-0070
Mailing address
404 N MADISON ST, QUINCY, FL 32351-1825
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA1160
FL
Other
Enumeration date
01/31/2007
Last updated
07/09/2007
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