National Provider Identifier

Elaine Theresa Desilva-Elich, CCC-LIC

Elaine Theresa Desilva-Elich, CCC-LIC is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Rochester, NY and a listed phone number of (585) 328-8228.

NPI 1073896817Rochester, NYSpeech-Language Pathologist

Profile Overview

NPI
1073896817
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
September 27, 2011
Last Updated
September 27, 2011

Practice Location

  • 88 Kirkland RD
  • Rochester, NY 14611-3137

Phone: (585) 328-8228

Mailing Address

  • 88 Kirkland Road
  • Adlai E Stevenson School No 29
  • Rochester, NY 14611

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1073896817
Entity Type
Individual
Last Name
Desilva-Elich
First Name
Elaine
Middle Name
Theresa
Name Prefix
Mrs.
Credential
CCC-LIC
Provider Other Last Name
Desilva
Provider Other First Name
Elaine
Provider Other Middle Name
Theresa
Provider Other Name Prefix Text
Miss
Provider Other Credential Text
CCC-LIC
Provider Other Last Name Type Code
1
Mailing Street Address
88 Kirkland Road
Mailing Address Line 2
Adlai E Stevenson School No 29
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14611
Mailing Country
US
Mailing Phone
(585) 328-8228
Mailing Fax
(585) 935-7429
Practice Street Address
88 Kirkland RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14611-3137
Practice Country
US
Practice Phone
(585) 328-8228
Practice Fax
(585) 935-7429
Enumeration Date
September 27, 2011
Last Updated
September 27, 2011
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)