Provider Demographics
NPI:1417115320
Name:TRUDEAU, ELIZA C (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZA
Middle Name:C
Last Name:TRUDEAU
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 1:12704 ALPERN CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-9008
Mailing Address - Country:US
Mailing Address - Phone:919-870-4635
Mailing Address - Fax:
Practice Address - Street 1:12704 ALPERN CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-9008
Practice Address - Country:US
Practice Address - Phone:919-870-4635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist