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Individual

ELIZABETH CHRISTINE RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1321 WYNNCREST CT, RALEIGH, NC 27603-8768
(919) 358-7089
(919) 326-2612
Mailing address
1321 WYNNCREST CT, RALEIGH, NC 27603-8768
(919) 358-7089
(919) 326-2612

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5219
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1279U
BCBS
NC
01
4600072
UNITED HEALTHCARE
01
7368432
AETNA
05
7411702
NC
01
8300041K
MEDICAID CBRS
NC
01
B6407
MEDCOST
Enumeration date
01/12/2007
Last updated
07/08/2007
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