Provider Demographics
NPI:1275699043
Name:DOTSON, ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DOTSON
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 1:60 CALEDONIA RD APT 110
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0906
Mailing Address - Country:US
Mailing Address - Phone:828-254-5180
Mailing Address - Fax:828-285-9144
Practice Address - Street 1:1063 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2650
Practice Address - Country:US
Practice Address - Phone:828-285-8814
Practice Address - Fax:828-285-9144
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5916235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C9971OtherMEDCOST
136EMOtherBLUECROSS
NC7412457Medicaid