Provider Demographics
NPI:1346862505
Name:MLAWSKI, ELISABETH AMY (PHD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:AMY
Last Name:MLAWSKI
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2419
Mailing Address - Country:US
Mailing Address - Phone:201-970-3511
Mailing Address - Fax:
Practice Address - Street 1:16 ELMWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2419
Practice Address - Country:US
Practice Address - Phone:201-970-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00406200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist