Provider Demographics
NPI:1477629251
Name:ELLEN GARRETT & ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ELLEN GARRETT & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:305-751-6648
Mailing Address - Street 1:149 NE 93RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2817
Mailing Address - Country:US
Mailing Address - Phone:305-751-6648
Mailing Address - Fax:305-758-1097
Practice Address - Street 1:149 NE 93RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2817
Practice Address - Country:US
Practice Address - Phone:305-751-6648
Practice Address - Fax:305-758-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty