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General NPI Number Information
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NPI Number | 1205398773
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Entity Type | Individual
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Provider Name | ELIZA A STAYTON SLP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 224 PHILLIP MORRIS DR STE 202
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City | SALISBURY
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State | MD
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Zip | 21804-2000
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Country | US
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Telephone | 302-217-3120
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Fax |
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Provider Business Mailing Address
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Address Line | 3819 RUMSEY DR
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City | TRAPPE
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State | MD
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Zip | 21673-1722
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Country | US
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Telephone | 443-504-9629
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Fax |
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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 | 08576
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License Number State | MD
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