Provider Demographics
NPI:1912440694
Name:LAWRENCE, ELENA D'AQUILI (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:D'AQUILI
Last Name:LAWRENCE
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 1:1902 WOODBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4342
Mailing Address - Country:US
Mailing Address - Phone:484-888-3380
Mailing Address - Fax:
Practice Address - Street 1:1902 WOODBROOK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4342
Practice Address - Country:US
Practice Address - Phone:484-888-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEO1-0001565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist