Provider Demographics
NPI:1538429949
Name:WINTERS, ELIZABETH MARIE (MA, CCC/L-SLP, TSSLD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:MA, CCC/L-SLP, TSSLD
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:DALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/L-SLP, TSSLD
Mailing Address - Street 1:18 CAROLINE LN
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1906
Mailing Address - Country:US
Mailing Address - Phone:716-440-3661
Mailing Address - Fax:
Practice Address - Street 1:2253 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2392
Practice Address - Country:US
Practice Address - Phone:716-834-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist