Provider Demographics
NPI:1184124208
Name:ELSBY, MISTY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:ELSBY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7090 N ORACLE RD
Mailing Address - Street 2:STE 178 #152
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4383
Mailing Address - Country:US
Mailing Address - Phone:520-222-8208
Mailing Address - Fax:
Practice Address - Street 1:9045 N SHADOW MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85704-6758
Practice Address - Country:US
Practice Address - Phone:520-222-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist