Provider Demographics
NPI:1386967842
Name:ELSHOFF, AMANDA KATHERINE (SLP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KATHERINE
Last Name:ELSHOFF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 W HOLLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47541-9704
Mailing Address - Country:US
Mailing Address - Phone:812-631-1681
Mailing Address - Fax:
Practice Address - Street 1:5732 W HOLLAND RD NE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:IN
Practice Address - Zip Code:47541
Practice Address - Country:US
Practice Address - Phone:812-631-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46001972A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist