Provider Demographics
NPI:1881189462
Name:SKELTON, ELI LAWRENCE (MS SLP-CFY)
Entity Type:Individual
Prefix:MR
First Name:ELI
Middle Name:LAWRENCE
Last Name:SKELTON
Suffix:
Gender:M
Credentials:MS SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47021 FRANCES HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-9241
Mailing Address - Country:US
Mailing Address - Phone:479-200-8462
Mailing Address - Fax:
Practice Address - Street 1:11723 OLD GLENN HWY STE 206
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7750
Practice Address - Country:US
Practice Address - Phone:907-301-4588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist