Individual
CAROL KOLDE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED CCC-SLP
Contact information
Practice address
6687 MEANDERING WAY, LAKEWOOD RANCH, FL 34202-1837
(941) 713-0399
Mailing address
6687 MEANDERING WAY, LAKEWOOD RANCH, FL 34202-1837
(941) 713-0399
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA5054
FL
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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