Provider Demographics
NPI:1932428349
Name:ISABELLA-VALENZI, ELISA RAE RAE (SLP)
Entity type:Individual
Prefix:
First Name:ELISA RAE
Middle Name:RAE
Last Name:ISABELLA-VALENZI
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 1:137 ETHAN ALLEN HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-6238
Mailing Address - Country:US
Mailing Address - Phone:203-559-9332
Mailing Address - Fax:203-544-9826
Practice Address - Street 1:137 ETHAN ALLEN HWY
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-6238
Practice Address - Country:US
Practice Address - Phone:203-559-9332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist