Provider Demographics
NPI:1033518394
Name:ELKIN, MICHELE SUZANNE (AUD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:SUZANNE
Last Name:ELKIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:ELKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:9566 137TH ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5118
Mailing Address - Country:US
Mailing Address - Phone:715-828-0197
Mailing Address - Fax:715-720-7758
Practice Address - Street 1:900 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6122
Practice Address - Country:US
Practice Address - Phone:715-717-4121
Practice Address - Fax:715-717-1480
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist