Provider Demographics
NPI:1558670927
Name:ANDREWS, ELIZABETH ANN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311 E STODDARD ST
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-1448
Mailing Address - Country:US
Mailing Address - Phone:573-820-2125
Mailing Address - Fax:
Practice Address - Street 1:481 N BEDFORD ST
Practice Address - Street 2:
Practice Address - City:PUXICO
Practice Address - State:MO
Practice Address - Zip Code:63960-9144
Practice Address - Country:US
Practice Address - Phone:573-222-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010030492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist