Provider Demographics
NPI:1154506293
Name:SLOAN, ELIZABETH KRISTA (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:KRISTA
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CRYSTAL SPRINGS RD
Mailing Address - Street 2:APARTMENT 415
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3124
Mailing Address - Country:US
Mailing Address - Phone:864-884-4188
Mailing Address - Fax:
Practice Address - Street 1:5 CRYSTAL SPRINGS RD
Practice Address - Street 2:APARTMENT 415
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3124
Practice Address - Country:US
Practice Address - Phone:864-884-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3397235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist