Provider Demographics
NPI:1235361809
Name:HOOVER, ELIZABETH LOUISE (MS, CCC-SLP, BC-NCD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MS, CCC-SLP, BC-NCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 DALY DRIVE EXT
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3316
Mailing Address - Country:US
Mailing Address - Phone:781-341-4818
Mailing Address - Fax:
Practice Address - Street 1:635 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1605
Practice Address - Country:US
Practice Address - Phone:617-353-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist