Provider Demographics
NPI:1003077397
Name:GUTTRIDGE, ELISE DAWN (MA)
Entity Type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:DAWN
Last Name:GUTTRIDGE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:ELISE
Other - Middle Name:DAWN
Other - Last Name:LEAVENWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8025 RITCHIE HWY SUITE 102
Mailing Address - Street 2:3D HEARING/BELTONE HEARING AID CENTER
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122
Mailing Address - Country:US
Mailing Address - Phone:410-590-5572
Mailing Address - Fax:410-695-3530
Practice Address - Street 1:8025 RITCHIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122
Practice Address - Country:US
Practice Address - Phone:410-590-5572
Practice Address - Fax:410-695-3530
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD728231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist