Provider Demographics
NPI:1396181632
Name:MESKER, ELIZABETH (SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MESKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-6450
Mailing Address - Country:US
Mailing Address - Phone:325-236-6821
Mailing Address - Fax:325-236-6112
Practice Address - Street 1:1104 HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-6450
Practice Address - Country:US
Practice Address - Phone:325-236-6821
Practice Address - Fax:325-236-6112
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist