Provider Demographics
NPI:1629042940
Name:FERGUSON, ELLEN KATHLEEN (MS CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:KATHLEEN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 PRAGER PLACE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508
Mailing Address - Country:US
Mailing Address - Phone:910-583-5581
Mailing Address - Fax:
Practice Address - Street 1:200 GASTON AVENUE
Practice Address - Street 2:MARION COUNTY BOARD OF EDUCATION
Practice Address - City:FARIMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2778
Practice Address - Country:US
Practice Address - Phone:910-583-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist