Provider Demographics
NPI:1922386820
Name:ULREICH-MORAN, ELIZABETH P (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:P
Last Name:ULREICH-MORAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ULREICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3 FARMERY LANE
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482
Mailing Address - Country:US
Mailing Address - Phone:203-522-1708
Mailing Address - Fax:
Practice Address - Street 1:3 FARMERY LANE
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482
Practice Address - Country:US
Practice Address - Phone:203-522-1708
Practice Address - Fax:203-583-3707
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004383235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist