Ellenbaum, Kelli Katharina

Ellenbaum, Kelli Katharina is an individual health care provider with primary practice located at 2625 N 19Th St , Bismarck ND 58503-0574. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Ellenbaum, Kelli Katharina can be contacted via phone (701) 222-3175.

Contact Information

Primary practice address
2625 N 19Th St Bismarck ND 58503-0574
Phone: (701) 222-3175
Fax: (701) 222-3186
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 862 North Dakota

Profile Details

NPI number 1003934878
LBN Legal business name Ellenbaum, Kelli Katharina
Credentials MS, CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Mar 15th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003934878 NPPES
North Dakota MEDICAID 1454835
North Dakota Other 27424
North Dakota MEDICAID 54627

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