Provider Demographics
NPI:1285324137
Name:ELIOT, VERONICA (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ELIOT
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:POPULUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCC-SLP
Mailing Address - Street 1:4592 BARDWELL DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-5219
Mailing Address - Country:US
Mailing Address - Phone:208-449-6552
Mailing Address - Fax:
Practice Address - Street 1:201 BAKERS RIDGE RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1500
Practice Address - Country:US
Practice Address - Phone:304-598-4300
Practice Address - Fax:304-598-4677
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK198384235Z00000X
IDSLP-4499235Z00000X
WVSLP-2440235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist