Healthcare Provider Details

I. General information

NPI: 1407778947
Provider Name (Legal Business Name): ELIZABETH MAYHEW MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 VILLAGE POINT DR
CLEMMONS NC
27012-8001
US

IV. Provider business mailing address

906 FORESTGLEN DR
WINSTON SALEM NC
27103-9721
US

V. Phone/Fax

Practice location:
  • Phone: 336-703-4148
  • Fax:
Mailing address:
  • Phone: 540-299-3562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: