Provider Demographics
NPI:1922378280
Name:ALRIC, ELLEN M (MA, CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:M
Last Name:ALRIC
Suffix:
Gender:F
Credentials:MA, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 STATE HIGHWAY 349
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-6836
Mailing Address - Country:US
Mailing Address - Phone:518-725-2780
Mailing Address - Fax:
Practice Address - Street 1:100 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BROADALBIN
Practice Address - State:NY
Practice Address - Zip Code:12025-2193
Practice Address - Country:US
Practice Address - Phone:518-954-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002781-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist