Provider Demographics
NPI:1376952366
Name:WEINBERG, ELLEN LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:LYNN
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-7321
Mailing Address - Country:US
Mailing Address - Phone:561-575-5552
Mailing Address - Fax:561-575-1934
Practice Address - Street 1:2103 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-7321
Practice Address - Country:US
Practice Address - Phone:561-575-5552
Practice Address - Fax:561-575-1934
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY881231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist