Provider Demographics
NPI:1992089411
Name:FARRELL, ELIZABETH ROSE (SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROSE
Last Name:FARRELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:165 MORNING WALK DR
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-1666
Mailing Address - Country:US
Mailing Address - Phone:215-491-6914
Mailing Address - Fax:
Practice Address - Street 1:165 MORNING WALK DR
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-1666
Practice Address - Country:US
Practice Address - Phone:215-491-6914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006100L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist