Provider Demographics
NPI:1396471389
Name:SAMPSON, ELIZABETH MARIE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIE
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 S FRIENDSWOOD DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-4580
Mailing Address - Country:US
Mailing Address - Phone:281-816-3067
Mailing Address - Fax:832-569-4696
Practice Address - Street 1:820 S FRIENDSWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-4543
Practice Address - Country:US
Practice Address - Phone:281-816-3067
Practice Address - Fax:832-569-4696
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105968235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist