Provider Demographics
NPI:1740592666
Name:MESCHER, ELIZABETH MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:MESCHER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:KLUESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CFY-SLP
Mailing Address - Street 1:5825 DRY CREEK LN NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-1225
Mailing Address - Country:US
Mailing Address - Phone:319-350-8018
Mailing Address - Fax:319-368-3626
Practice Address - Street 1:5825 DRY CREEK LN NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-1225
Practice Address - Country:US
Practice Address - Phone:319-350-8018
Practice Address - Fax:319-368-3626
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665950Medicaid
IA0665950Medicaid