Provider Demographics
NPI:1376814822
Name:ELSIK, JANNA LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:LYNN
Last Name:ELSIK
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 WILLOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-8704
Mailing Address - Country:US
Mailing Address - Phone:479-684-3132
Mailing Address - Fax:479-684-3098
Practice Address - Street 1:5501 WILLOW CREEK DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-8704
Practice Address - Country:US
Practice Address - Phone:479-684-3132
Practice Address - Fax:479-684-3098
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-14
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2453235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist