Provider Demographics
NPI:1598946592
Name:CHEW, ELIZABETH PETERSON (MS,CCC-SLP,CEIS)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:PETERSON
Last Name:CHEW
Suffix:
Gender:F
Credentials:MS,CCC-SLP,CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 ROCK ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3438
Mailing Address - Country:US
Mailing Address - Phone:508-675-5778
Mailing Address - Fax:508-675-9889
Practice Address - Street 1:636 ROCK ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3438
Practice Address - Country:US
Practice Address - Phone:508-675-5778
Practice Address - Fax:508-675-9889
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3442235Z00000X
RISP00431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist