Provider Demographics
NPI:1740040849
Name:DEPINTO, ELIZABETH MERLE JAHRAUS (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MERLE JAHRAUS
Last Name:DEPINTO
Suffix:
Gender:F
Credentials: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 1:1631 N OLD COLONY
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-2001
Mailing Address - Country:US
Mailing Address - Phone:720-499-6500
Mailing Address - Fax:
Practice Address - Street 1:3961 E GUADALUPE RD STE 1
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-3266
Practice Address - Country:US
Practice Address - Phone:480-699-4845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP13053235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist