Provider Demographics
NPI:1326353467
Name:WEILER, ELLEN KAE (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:KAE
Last Name:WEILER
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6644 SE SHAWNEE HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BERRYTON
Mailing Address - State:KS
Mailing Address - Zip Code:66409-9246
Mailing Address - Country:US
Mailing Address - Phone:785-633-2514
Mailing Address - Fax:
Practice Address - Street 1:7220 SW ASBURY DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4706
Practice Address - Country:US
Practice Address - Phone:785-478-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist