Provider Demographics
NPI:1801251418
Name:MCSPADDEN, ELLEN (MA, CCC-SLP, CAS)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:MCSPADDEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1602
Mailing Address - Country:US
Mailing Address - Phone:856-577-0966
Mailing Address - Fax:856-558-9901
Practice Address - Street 1:1010 HADDONFIELD BERLIN RD STE 404
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3516
Practice Address - Country:US
Practice Address - Phone:856-577-0966
Practice Address - Fax:856-558-9901
Is Sole Proprietor?:No
Enumeration Date:2015-12-24
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00470800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist