Provider Demographics
NPI:1417262429
Name:DELSANDRO, ELIZABETH MARY
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY
Last Name:DELSANDRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MARY
Other - Last Name:PELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:250 HAWKINS DR. UNIVERSITY OF IOWA
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1012
Mailing Address - Country:US
Mailing Address - Phone:319-335-8736
Mailing Address - Fax:
Practice Address - Street 1:250 HAWKINS DR. UNIVERSITY OF IOWA
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1012
Practice Address - Country:US
Practice Address - Phone:319-335-8736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002065235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist