Provider Demographics
NPI:1558939504
Name:PURSELL, ELIZABETH QUINN (MAT, MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:QUINN
Last Name:PURSELL
Suffix:
Gender:F
Credentials:MAT, MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4135 N HIGHWAY 11 SE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:IN
Mailing Address - Zip Code:47117-7832
Mailing Address - Country:US
Mailing Address - Phone:502-445-7686
Mailing Address - Fax:
Practice Address - Street 1:708 HIGHLANDER POINT DR
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9442
Practice Address - Country:US
Practice Address - Phone:502-430-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270925235Z00000X
IN22007419A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist