Provider Demographics
NPI:1942490636
Name:JONES, ELIZABETH RUTH (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:RUTH
Last Name:JONES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2216
Mailing Address - Country:US
Mailing Address - Phone:205-314-7227
Mailing Address - Fax:205-314-7222
Practice Address - Street 1:1901A BUENA VISTA AVE
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3178
Practice Address - Country:US
Practice Address - Phone:417-358-3440
Practice Address - Fax:417-358-7343
Is Sole Proprietor?:No
Enumeration Date:2007-07-28
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#485235Z00000X
MO2012012181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARSP#485OtherSTATE LICENSE
01075819OtherNATIONAL CERTIFICATE
MO2012012181OtherSP