Elyse Wahlquist Van Wagenen, MA CCC SLP | |
11287 Nw State Road 20, Bristol, FL 32321-3414 | |
(850) 694-4420 | |
Not Available |
Full Name | Elyse Wahlquist Van Wagenen |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 11287 Nw State Road 20, Bristol, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346807476 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | SLPCF000042 (District Of Columbia) | Secondary |
235Z00000X | Speech-language Pathologist | SA17587 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
Elyse Wahlquist Van Wagenen, MA CCC SLP 11287 Nw State Road 20, Bristol, FL 32321-3414 Ph: (850) 694-4420 | Elyse Wahlquist Van Wagenen, MA CCC SLP 11287 Nw State Road 20, Bristol, FL 32321-3414 Ph: (850) 694-4420 |
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