Healthcare Provider Details
I. General information
NPI: 1841528684
Provider Name (Legal Business Name): ELISABETH MARTIN LAWSON M.ED. CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2009
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
328 NEFF AVE.
HARRISONBURG VA
22801
US
IV. Provider business mailing address
328 NEFF AVE.
HARRISONBURG VA
22801
US
V. Phone/Fax
- Phone: 540-437-4226
- Fax: 540-437-4227
- Phone: 540-437-4226
- Fax: 540-437-4227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 2202005762 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: