Individual
ELAINE M VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1000 EDDY ST., PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY ST., PROVIDENCE, RI 02905
(401) 533-9100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00163
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2092
EI NHPRC
RI
01
—
292177
EI BCROSS
RI
01
—
408063
BCHIP NUMBER
RI
01
—
412296
EI BCHIP
RI
01
—
4600103
EI UHP
RI
05
—
ES01788
—
RI
Enumeration date
07/12/2006
Last updated
07/09/2007
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