Provider Demographics
NPI:1437529187
Name:ELLEFSON, JEANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:ELLEFSON
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 1:3215 CUMING ST
Mailing Address - Street 2:ROOM 4-176
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2000
Mailing Address - Country:US
Mailing Address - Phone:402-557-2383
Mailing Address - Fax:402-557-2379
Practice Address - Street 1:3215 CUMING ST
Practice Address - Street 2:ROOM 4-176
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2000
Practice Address - Country:US
Practice Address - Phone:402-557-2383
Practice Address - Fax:402-557-2379
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist