Doctor Name: | ELIZABETH A. FAUSONE |
NPI Number: | 1073845483 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS,CCC,SLP |
License Number: | |
Business Practice Address: | 2635 Berwyck Rd Se East Grand Rapids, MI - 495064826 |
Business Phone Number: | 6169420380 |
Business Fax Number: | |
Mailing Address: | 2635 Berwyck Rd Se, EAST GRAND RAPIDS |
State: | MI |
Postal Code: | 495064826 |
Phone Number: | 6169420380 |
Fax Number: | |
NPI Enumeration Date: | 02/10/2010 |
NPI Last Update Date: | 02/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |