Provider Demographics
NPI:1376816926
Name:ELMRHARRI, EVELYN TRISTINE (STA)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:TRISTINE
Last Name:ELMRHARRI
Suffix:
Gender:F
Credentials:STA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N MAIN ST
Mailing Address - Street 2:STE. A
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-1623
Mailing Address - Country:US
Mailing Address - Phone:830-816-5453
Mailing Address - Fax:830-816-5405
Practice Address - Street 1:711 N MAIN ST
Practice Address - Street 2:STE. A
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1623
Practice Address - Country:US
Practice Address - Phone:830-816-5453
Practice Address - Fax:830-816-5405
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363772355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant