Provider Demographics
NPI:1033388095
Name:ELLIS, RIAH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RIAH
Middle Name:
Last Name:ELLIS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 S FORT APACHE RD
Mailing Address - Street 2:STE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-7695
Mailing Address - Country:US
Mailing Address - Phone:702-641-8255
Mailing Address - Fax:
Practice Address - Street 1:5552 S FORT APACHE RD
Practice Address - Street 2:STE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7695
Practice Address - Country:US
Practice Address - Phone:702-641-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist