Individual
MS. ELLI EMMANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. C.C.C. /S.L.P
Contact information
Practice address
1440 PARK SHORE CIR, #1, FORT MYERS, FL 33901-9614
(239) 826-3593
Mailing address
1440 PARK SHORE CIR, #1, FORT MYERS, FL 33901-9614
(239) 826-3593
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA1179
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001505300
—
FL
05
—
812311000
—
FL
05
—
880500800
—
FL
Enumeration date
09/16/2006
Last updated
02/20/2017
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