Provider Demographics
NPI:1407094345
Name:FISHER, ELAINE ELIZABETH (CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ELIZABETH
Last Name:FISHER
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:ELIZABETH
Other - Last Name:RANSFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:NY
Mailing Address - Zip Code:13077
Mailing Address - Country:US
Mailing Address - Phone:607-423-8950
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:NY
Practice Address - Zip Code:13077
Practice Address - Country:US
Practice Address - Phone:607-423-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009886-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist