Provider Demographics
NPI:1114236049
Name:DAIRE, ELIZABETH A (SPEECH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:DAIRE
Suffix:
Gender:F
Credentials:SPEECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-0366
Mailing Address - Country:US
Mailing Address - Phone:816-331-0050
Mailing Address - Fax:816-331-2010
Practice Address - Street 1:21005 S SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9346
Practice Address - Country:US
Practice Address - Phone:816-331-0050
Practice Address - Fax:816-331-2010
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist