Individual
JENNIFER RUTH ELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
439 CAROL LN, SHOREVIEW, MN 55126-4705
(612) 308-6132
(651) 414-9339
Mailing address
PO BOX 11, CIRCLE PINES, MN 55014-0011
(612) 308-6132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12017360
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4600414
MEDICA
MN
01
—
4DY03SP
BCBS
MN
05
—
807953600
—
MN
01
—
HP34980
HEALTH PARTNERS
MN
Enumeration date
04/25/2006
Last updated
11/08/2011
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