Individual
CINTAMANI H. ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1215 N BEAVER ST, FLAGSTAFF, AZ 86001-3126
(928) 773-2125
(928) 773-2419
Mailing address
1215 N BEAVER ST, FLAGSTAFF, AZ 86001-3126
(928) 773-2125
(928) 773-2419
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP5758
AZ
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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