Ellaine L Abalos, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Glastonbury, CT
NPI 1205150281 · NPPES record last updated Mar 20, 2010
Key facts
- NPI
- 1205150281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4091 (CT)
- Practice address
- 72 Salmon Brook Dr
Glastonbury, CT 06033-2131 - Phone
- (860) 633-5244
- NPI assigned
- Mar 20, 2010
- Sex
- Female
- Sole proprietor
- No
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4091 | CT | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4091 | CT | Yes |
Addresses
Primary practice location
72 Salmon Brook Dr
Glastonbury, CT 06033-2131
Mailing address
72 Salmon Brook Dr
Glastonbury, CT 06033-2131
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All providers in Glastonbury, CT · Speech-Language Pathologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.