Provider Demographics
NPI:1861854960
Name:GEIGER, ELISHANN (SLP)
Entity Type:Individual
Prefix:
First Name:ELISHANN
Middle Name:
Last Name:GEIGER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12371 S KIRKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2836
Mailing Address - Country:US
Mailing Address - Phone:713-995-9292
Mailing Address - Fax:713-779-0204
Practice Address - Street 1:555 BURNS AVE
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-3335
Practice Address - Country:US
Practice Address - Phone:863-679-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109378235Z00000X
WYSP-895235Z00000X
FLSA14607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist