Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elyse Wahlquist Van Wagenen, MACCCSLP

Individual provider Speech-Language Pathologist · NPI 1346807476

Elyse Wahlquist Van Wagenen, MACCCSLP is a Speech-Language Pathologist in Bristol, Florida. Works from 3 locations. Licensed in District of Columbia and Florida.

Licensed in
DC, FL
In the registry since
2019
Specialties on file
2

Practice location Address checks out

11287 NW State Road 20
Bristol, FL 32321-3414
Phone: (850) 694-4420
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2600 Douglass Rd Se, Washington, Dc, DC 20020 — (850) 694-4429
  • 2930 Capital Medical Blvd, Tallahassee, FL 32308-4408 — (850) 694-4420

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA17587 (FL)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SLPCF000042 (DC)

Record details

NPI number1346807476
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCCSLP
Sole proprietorNo
NPI enumeratedMay 23, 2019
Last updated in NPPESDecember 2, 2024
Certification dateDecember 2, 2024

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