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General NPI Number Information
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NPI Number | 1174886089
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Entity Type | Individual
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Provider Name | ELIZABETH ANN LILES M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 4219 BEE CREEK ROAD
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City | AUSTIN
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State | TX
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Zip | 78738-7873
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Country | US
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Telephone | 512-533-3021
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Fax | 737-931-3000
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Provider Business Mailing Address
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Address Line | 5110 S. YALE AVE. THERAPY 4 KIDS
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City | TULSA
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State | OK
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Zip | 74135
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Country | US
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Telephone | 918-492-2386
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Fax | 918-645-8686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4175
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 263107912
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 115414
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License Number State | TX
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