Provider Demographics
NPI:1134692197
Name:ELIZABETH ANNE CRIQUI; M.ED.,CCC/SLP
Entity Type:Organization
Organization Name:ELIZABETH ANNE CRIQUI; M.ED.,CCC/SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CRIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MED,CCC/SLP
Authorized Official - Phone:804-357-9626
Mailing Address - Street 1:135 PONDS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3798
Mailing Address - Country:US
Mailing Address - Phone:804-357-9626
Mailing Address - Fax:
Practice Address - Street 1:135 PONDS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3798
Practice Address - Country:US
Practice Address - Phone:804-357-9626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty