Individual
MRS. KERI KRISTINE ELLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED CCC-SLP
Contact information
Practice address
4540 E OLNEY AVE, HIGLEY, AZ 85236-3657
(480) 813-8599
Mailing address
4540 E OLNEY AVE, HIGLEY, AZ 85236-3657
(480) 813-8599
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0292
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12029472
ASHA NUMBER
AZ
01
—
486614
ACCESS NUMBER
AZ
Enumeration date
11/30/2006
Last updated
07/08/2007
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