Elizabeth Connell Anttonen, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Greenwood, IN

NPI 1104055979 · NPPES record last updated Jul 14, 2009

Key facts

NPI
1104055979
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
22002647A (IN)
Practice address
1193 Clark Dr
Greenwood, IN 46143-3147
Phone
(317) 881-2262
NPI assigned
Jul 14, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22002647AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collaborating for Kids, LLC Past
since Feb 19, 2016
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22002647A IN Yes

Addresses

Primary practice location

1193 Clark Dr
Greenwood, IN 46143-3147

Mailing address

1193 Clark Drive
Greenwood, IN 46143-3147
Phone (317) 881-2262

Other providers in Greenwood, IN

All providers in Greenwood, IN · Speech-Language Pathologist in Indiana

Sources for this page

Verify at the official NPI Registry.