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NPI Code Detail

MEDICARE: MS. ELIZABETH EATON MSW, LCSW

MEDICARE:  MS. ELIZABETH  EATON  MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker002559MO

General Provider Information

NPI Number : 1194881870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH EATON MSW, LCSW
Provider Business Mailing Address
First Line : 801 S WOODLAWN
Second Line : SUITE 29
City : O FALLON
State : MO
Zip : 63366-7646
Country : US
Telephone Number : 636-379-1779
Fax Number :
Provider Business Practice Location Address
First Line : 801 S WOODLAWN
Second Line : SUITE 29
City : O FALLON
State : MO
Zip : 63366-7646
Country : US
Telephone Number : 636-379-1779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 05/20/2009

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Directions to “ MS. ELIZABETH EATON MSW, LCSW” Practice Location

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