Provider Demographics
NPI:1467987206
Name:EUSTON, ELIZABETH DANIELLE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DANIELLE
Last Name:EUSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 FOX TROT CT
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:AR
Mailing Address - Zip Code:72938-3318
Mailing Address - Country:US
Mailing Address - Phone:479-252-8174
Mailing Address - Fax:
Practice Address - Street 1:508 FOX TROT CT
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:AR
Practice Address - Zip Code:72938-3318
Practice Address - Country:US
Practice Address - Phone:479-252-8174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist