Provider Demographics
NPI:1871282970
Name:KRAMERSON, ELISSA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELISSA
Middle Name:
Last Name:KRAMERSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BAYWOODS DR
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2819
Mailing Address - Country:US
Mailing Address - Phone:619-944-4339
Mailing Address - Fax:
Practice Address - Street 1:6 BAYWOODS DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464-2819
Practice Address - Country:US
Practice Address - Phone:619-944-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15019235Z00000X
MA7871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist