Provider Demographics
NPI:1275195174
Name:NASSER, ELISE ANNE
Entity Type:Individual
Prefix:MISS
First Name:ELISE
Middle Name:ANNE
Last Name:NASSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7612
Mailing Address - Country:US
Mailing Address - Phone:989-323-2090
Mailing Address - Fax:
Practice Address - Street 1:2535 22ND ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7612
Practice Address - Country:US
Practice Address - Phone:989-323-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist