Provider Demographics
NPI:1770736639
Name:WESTFALL, ELIZABETH B (MSP, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:W
Other - Last Name:PATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSP, CCC-SLP
Mailing Address - Street 1:210 DAHLONEGA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3158
Mailing Address - Country:US
Mailing Address - Phone:770-751-1589
Mailing Address - Fax:678-807-8819
Practice Address - Street 1:210 DAHLONEGA ST STE 100
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3158
Practice Address - Country:US
Practice Address - Phone:770-751-1589
Practice Address - Fax:678-807-8819
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP005221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist