Provider Demographics
NPI:1003159658
Name:ABTS, ELIZABETH CHRISTINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHRISTINE
Last Name:ABTS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ABTS
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:8101 THEODORE DAWES RD W
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-9409
Mailing Address - Country:US
Mailing Address - Phone:251-581-5659
Mailing Address - Fax:
Practice Address - Street 1:8101 THEODORE DAWES RD W
Practice Address - Street 2:
Practice Address - City:THEODORE
Practice Address - State:AL
Practice Address - Zip Code:36582-9409
Practice Address - Country:US
Practice Address - Phone:251-581-5659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3315235Z00000X
MD06239235Z00000X
CA16994235Z00000X
OR14087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist