Provider Demographics
NPI:1306279625
Name:PATTON, ELIZABETH MELROSE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MELROSE
Last Name:PATTON
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 1:7588 LONG VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-9747
Mailing Address - Country:US
Mailing Address - Phone:917-583-4886
Mailing Address - Fax:
Practice Address - Street 1:115 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4539
Practice Address - Country:US
Practice Address - Phone:980-819-1580
Practice Address - Fax:949-561-4742
Is Sole Proprietor?:No
Enumeration Date:2013-08-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13533235Z00000X
NVSP-1321235Z00000X
NC12980235Z00000X
14047739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist