Healthcare Provider Details

I. General information

NPI: 1215085865
Provider Name (Legal Business Name): ELIZABETH HEPLER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6396 CHALMERS CT
SUMMERFIELD NC
27358-9077
US

IV. Provider business mailing address

6396 CHALMERS CT
SUMMERFIELD NC
27358-9077
US

V. Phone/Fax

Practice location:
  • Phone: 133-643-0239
  • Fax:
Mailing address:
  • Phone: 336-430-2398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7332
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: