Provider Demographics
NPI:1013035054
Name:SCHAAD, ELLEN K (MA,CCC,LSP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:K
Last Name:SCHAAD
Suffix:
Gender:F
Credentials:MA,CCC,LSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11489 DANCING RIVER DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-4127
Mailing Address - Country:US
Mailing Address - Phone:941-497-7060
Mailing Address - Fax:
Practice Address - Street 1:11489 DANCING RIVER DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4127
Practice Address - Country:US
Practice Address - Phone:941-497-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1136235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist