Individual
JENNIFER L ELOMAA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCCCSLP
Contact information
Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00951
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058
NHP
RI
01
—
4600103
UNITED
RI
05
—
9009994
—
RI
01
—
99947
BLUE CROSS
—
Enumeration date
09/24/2007
Last updated
09/24/2007
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