Provider Demographics
NPI:1376776609
Name:BLOCH, ELLEN WOLFF (BS,MA)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:WOLFF
Last Name:BLOCH
Suffix:
Gender:F
Credentials:BS,MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NW 82ND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1834
Mailing Address - Country:US
Mailing Address - Phone:954-236-0200
Mailing Address - Fax:954-474-3405
Practice Address - Street 1:100 NW 82ND AVE STE 104
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1834
Practice Address - Country:US
Practice Address - Phone:954-236-0200
Practice Address - Fax:954-474-3405
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2011-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1125231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist