Individual
JANE M ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
200 S EXECUTIVE DR, SUITE 101, BROOKFIELD, WI 53005-4216
(888) 964-6681
(888) 662-0859
Mailing address
25 NEEDHAM ST, NEWTON, MA 02461-1615
(617) 964-6681
(617) 630-0141
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
477-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41152700
—
WI
Enumeration date
12/19/2006
Last updated
03/02/2012
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