Provider Demographics
NPI:1730200544
Name:ELLIOTT, NORMA HOUCHIN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:HOUCHIN
Last Name:ELLIOTT
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:PO BOX 692
Mailing Address - Street 2:415 NE EVERGREEN LANE
Mailing Address - City:YACHATS
Mailing Address - State:OR
Mailing Address - Zip Code:97498-0692
Mailing Address - Country:US
Mailing Address - Phone:541-272-0707
Mailing Address - Fax:541-547-4226
Practice Address - Street 1:415 NE EVERGREEN LANE
Practice Address - Street 2:
Practice Address - City:YACHATS
Practice Address - State:OR
Practice Address - Zip Code:97498-0692
Practice Address - Country:US
Practice Address - Phone:541-272-0707
Practice Address - Fax:541-547-4226
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12724235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist