Provider Demographics
NPI:1194296301
Name:CARTER, ELIZABETH ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:JANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7421 S. OUTER 364, SUITE B
Mailing Address - Street 2:
Mailing Address - City:DARDENNE PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63368
Mailing Address - Country:US
Mailing Address - Phone:636-561-2060
Mailing Address - Fax:636-561-4380
Practice Address - Street 1:7421 S. OUTER 364, SUITE B
Practice Address - Street 2:
Practice Address - City:DARDENNE PRAIRIE
Practice Address - State:MO
Practice Address - Zip Code:63368
Practice Address - Country:US
Practice Address - Phone:636-561-2060
Practice Address - Fax:636-561-4380
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018032342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist