Provider Demographics
NPI:1386003226
Name:LAMPHIER, ELYSE
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:LAMPHIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16341 REDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9178
Mailing Address - Country:US
Mailing Address - Phone:810-373-9507
Mailing Address - Fax:
Practice Address - Street 1:202 W SHIAWASSEE AVE
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2093
Practice Address - Country:US
Practice Address - Phone:810-373-9507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-21
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101004570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist