Provider Demographics
NPI:1871727107
Name:STRONG, ELIZABETH JOYCE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JOYCE
Last Name:STRONG
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:UT
Mailing Address - Zip Code:84333-1774
Mailing Address - Country:US
Mailing Address - Phone:435-258-6678
Mailing Address - Fax:435-258-6566
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:UT
Practice Address - Zip Code:84333-1774
Practice Address - Country:US
Practice Address - Phone:435-258-6678
Practice Address - Fax:435-258-6566
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7291571-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT26-4694416Medicaid
ID26-4694416Medicaid
ID26-4694416Medicare PIN
UT26-4694416Medicare PIN