Provider Demographics
NPI:1467174912
Name:SANCHEZ, ELYSIA I
Entity type:Individual
Prefix:
First Name:ELYSIA
Middle Name:
Last Name:SANCHEZ
Suffix:I
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 1:15843 CRABBS BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-6623
Mailing Address - Country:US
Mailing Address - Phone:301-869-7505
Mailing Address - Fax:
Practice Address - Street 1:15843 CRABBS BRANCH WAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-6623
Practice Address - Country:US
Practice Address - Phone:301-869-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2025-08-01
Deactivation Date:2025-06-20
Deactivation Code:
Reactivation Date:2025-07-31
Provider Licenses
StateLicense IDTaxonomies
MD03142L235Z00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician