Provider Demographics
NPI:1710393467
Name:CRAFT, ELIZABETH C (HAS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:CRAFT
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:C
Other - Last Name:EBIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HAS
Mailing Address - Street 1:1273 COFFEEN AVE
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5325
Mailing Address - Country:US
Mailing Address - Phone:307-674-8920
Mailing Address - Fax:307-674-1916
Practice Address - Street 1:1273 COFFEEN AVE
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5325
Practice Address - Country:US
Practice Address - Phone:307-674-8920
Practice Address - Fax:307-674-1916
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY170237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist