Provider Demographics
NPI:1164866448
Name:ELIE, MARTINE (PHD CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:MARTINE
Middle Name:
Last Name:ELIE
Suffix:
Gender:F
Credentials:PHD CCC-SLP
Other - Prefix:DR
Other - First Name:MARTINE
Other - Middle Name:
Other - Last Name:ELIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD CCC-SLP
Mailing Address - Street 1:2024 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3027
Mailing Address - Country:US
Mailing Address - Phone:202-865-6679
Mailing Address - Fax:202-865-3261
Practice Address - Street 1:525 BRYANT ST NW RM 139Y
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-1005
Practice Address - Country:US
Practice Address - Phone:202-806-6991
Practice Address - Fax:202-387-1327
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP000234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist