MEDICARE: DR. ELIZABETH ELLEN SPERRY SC.D., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	19138	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346223427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ELLEN SPERRY SC.D., CCC-SLP

Provider Business Mailing Address
First Line	:	11970 N CENTRAL EXPY
Second Line	:	SUITE 270
City	:	DALLAS
State	:	TX
Zip	:	75243-3768
Country	:	US
Telephone Number	:	972-331-1900
Fax Number	:	972-331-1909

Provider Business Practice Location Address
First Line	:	11970 N CENTRAL EXPY
Second Line	:	SUITE 270
City	:	DALLAS
State	:	TX
Zip	:	75243-3768
Country	:	US
Telephone Number	:	972-331-1900
Fax Number	:	972-331-1909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/26/2012

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Directions to “ DR. ELIZABETH ELLEN SPERRY SC.D., CCC-SLP” Practice Location

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