Provider Demographics
NPI:1619591971
Name:TVARDZIK, ELLI MORIAH (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ELLI
Middle Name:MORIAH
Last Name:TVARDZIK
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 POSEY ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2965
Mailing Address - Country:US
Mailing Address - Phone:240-498-4951
Mailing Address - Fax:
Practice Address - Street 1:80 MADDEX DR
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-4305
Practice Address - Country:US
Practice Address - Phone:304-876-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist