Individual
MS. ELISE RENEE HANCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
50 POND ST, NEWPORT, VT 05855-4825
(802) 279-5847
Mailing address
209 CONGRESS ST # 1, MORRISVILLE, VT 05661-6049
(802) 279-5847
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12069791
AMERICAN SPEECH AND HEARING ASSOCIATION
VT
Enumeration date
12/27/2012
Last updated
12/27/2012
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