Ellen Cleveland, SLP

Individual provider Active NPI Speech-Language Pathologist · Palestine, TX

NPI 1568084697 · NPPES record last updated May 12, 2020

Key facts

NPI
1568084697
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
114446 (TX)
Practice address
2702 Bentwood Dr
Palestine, TX 75803-9589
Phone
(903) 274-6421
NPI assigned
May 12, 2020
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

State licenses

LicenseStateTypeSpecialty
114446TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 114446 TX Yes

Addresses

Primary practice location

2702 Bentwood Dr
Palestine, TX 75803-9589

Mailing address

2702 Bentwood Dr
Palestine, TX 75803-9589

Other providers in Palestine, TX

All providers in Palestine, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.