Provider Demographics
NPI:1669930368
Name:ELLIOTT, MADELYN LEIGH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:LEIGH
Last Name:ELLIOTT
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 1:6712 RIVER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8245
Mailing Address - Country:US
Mailing Address - Phone:336-370-5004
Mailing Address - Fax:
Practice Address - Street 1:6712 RIVER HILLS DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8245
Practice Address - Country:US
Practice Address - Phone:336-370-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist