Provider Demographics
NPI:1194370064
Name:NEJADI, ELLAHE
Entity type:Individual
Prefix:
First Name:ELLAHE
Middle Name:
Last Name:NEJADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 SETON DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3210
Mailing Address - Country:US
Mailing Address - Phone:410-358-8270
Mailing Address - Fax:
Practice Address - Street 1:2540 N SCRANTON CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7127
Practice Address - Country:US
Practice Address - Phone:303-524-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09528235Z00000X
CO0005441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist