Basic Information
| Provider Information | |||||||||
| NPI: | 1295349835 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABEL | ||||||||
| FirstName: | ELISE | ||||||||
| MiddleName: | CAROLINE | ||||||||
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| Credential: | M.A., CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 964 N 7TH RD | ||||||||
| Address2: | |||||||||
| City: | COOS BAY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974202413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236679703 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2085 INLAND DR | ||||||||
| Address2: | |||||||||
| City: | NORTH BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974591203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412675221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2020 | ||||||||
| LastUpdateDate: | 09/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | OR | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.