Provider Demographics
NPI:1265924658
Name:ELKINS, AVERY MORGAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:MORGAN
Last Name:ELKINS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 LILY WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-1775
Mailing Address - Country:US
Mailing Address - Phone:256-558-2460
Mailing Address - Fax:
Practice Address - Street 1:2631 LILY WAY
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-1775
Practice Address - Country:US
Practice Address - Phone:256-558-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4270235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist