Provider Demographics
NPI:1013292747
Name:ZERAFA, ELLEN M (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:M
Last Name:ZERAFA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:M
Other - Last Name:CLOUTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9011 SADDLE HORN DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1211
Mailing Address - Country:US
Mailing Address - Phone:248-860-4103
Mailing Address - Fax:
Practice Address - Street 1:2413 S LINDEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5428
Practice Address - Country:US
Practice Address - Phone:810-733-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist