Basic Information
| Provider Information | |||||||||
| NPI: | 1770689291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAUNDERS | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | JEANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4395 STATE ROUTE 38B | ||||||||
| Address2: | |||||||||
| City: | NEWARK VALLEY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138115531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077863981 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 18 BROAD ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137902106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077987117 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 014526 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.