Provider Demographics
NPI:1871504480
Name:SALEM, ELAINE (MA/CCC-A)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:SALEM
Suffix:
Gender:F
Credentials:MA/CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 EAST BLVD
Mailing Address - Street 2:AUDIOLOGY SERVICE 126W
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1782
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:VAMC AUDIOLOGY SERVICE 126W
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1782
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01356231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist