Provider Demographics
NPI:1164311064
Name:BABB, ELISABETH CAMPBELL
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:CAMPBELL
Last Name:BABB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 CARTERETT AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4222
Mailing Address - Country:US
Mailing Address - Phone:843-813-1977
Mailing Address - Fax:
Practice Address - Street 1:1704 CARTERETT AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4222
Practice Address - Country:US
Practice Address - Phone:843-813-1977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist