Provider Demographics
NPI:1184859977
Name:SIEWERT, ELIZABETH ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:SIEWERT
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 GOVERNORS CIR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1441
Mailing Address - Country:US
Mailing Address - Phone:610-873-1744
Mailing Address - Fax:
Practice Address - Street 1:215 CHURCH ST
Practice Address - Street 2:3RD. FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4518
Practice Address - Country:US
Practice Address - Phone:800-974-6383
Practice Address - Fax:800-974-4241
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004289L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist