Provider Demographics
NPI:1255867313
Name:GREENWOOD, ELIZABETH (MS/CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:MS/CCC/SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:TIERNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC/SLP
Mailing Address - Street 1:677 COURT ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1702
Mailing Address - Country:US
Mailing Address - Phone:603-354-4157
Mailing Address - Fax:
Practice Address - Street 1:677 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1702
Practice Address - Country:US
Practice Address - Phone:603-354-4157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist