Provider Demographics
NPI:1033094966
Name:FIALKOWSKI, ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FIALKOWSKI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S 2ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-2172
Mailing Address - Country:US
Mailing Address - Phone:660-885-2394
Mailing Address - Fax:660-383-1650
Practice Address - Street 1:210 S 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MO
Practice Address - Zip Code:64735-2172
Practice Address - Country:US
Practice Address - Phone:660-885-2394
Practice Address - Fax:660-383-1650
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024033063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist