Individual
MS. ELENA KALOUSTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6821 EDEN LN, TAMPA, FL 33634-4711
(813) 243-0730
Mailing address
6821 EDEN LN, TAMPA, FL 33634-4711
(813) 352-8005
(813) 515-5458
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA9469
FL
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000279000
—
FL
05
—
891983600
—
FL
Enumeration date
02/20/2007
Last updated
11/26/2018
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