Individual
ANDREA ROSE ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3550 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1572
(616) 531-5025
Mailing address
3550 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1572
(616) 531-5025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101006182
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7101006182
MICHIGAN LICENSE
MI
Enumeration date
07/01/2019
Last updated
04/14/2022
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