Provider Demographics
NPI:1396155438
Name:THOMAS, ELIZABETH ERIN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ERIN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ERIN
Other - Last Name:SAMSELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:797 WOODLAND DR
Mailing Address - Street 2:STE 102
Mailing Address - City:STUART
Mailing Address - State:VA
Mailing Address - Zip Code:24171-5132
Mailing Address - Country:US
Mailing Address - Phone:276-694-0124
Mailing Address - Fax:276-694-0125
Practice Address - Street 1:797 WOODLAND DR
Practice Address - Street 2:STE 102
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171-5132
Practice Address - Country:US
Practice Address - Phone:276-694-0124
Practice Address - Fax:276-694-0125
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006214235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist