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General NPI Number Information
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NPI Number | 1538273149
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Entity Type | Individual
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Provider Name | ELIZABETH A MUELLER SLP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 723 INSIGHT AVE STE 300
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City | O FALLON
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State | IL
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Zip | 62269-2193
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Country | US
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Telephone | 618-607-0086
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Fax | 618-607-0042
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Provider Business Mailing Address
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Address Line | 2654 MERIDIAN LAKE DR
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City | BELLEVILLE
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State | IL
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Zip | 62221-3365
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Country | US
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Telephone | 618-624-8143
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Fax | 618-624-8143
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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 | 146006258
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License Number State | IL
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