Elyse Wahlquist Van Wagenen, MA CCC SLP

NPI #1346807476 in Bristol, Florida

Provider Information

NPI Number
1346807476
Entity Type
Individual
Name
Elyse Wahlquist Van Wagenen, MA CCC SLP
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Speech-Language Pathologist
Credential
MA CCC SLP
Enumeration Date
May 23, 2019
Last Updated
Dec 2, 2024

Practice Location

Address
11287 NW STATE ROAD 20
State
Florida
ZIP Code
32321-3414
Phone
(850) 694-4420

Specialties & Taxonomy Codes

Specialty
Speech-Language Pathologist

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