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

LicenseStateTypeSpecialty
4091CTMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Glastonbury, CT

All providers in Glastonbury, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.