Individual
ELIZABETH L SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7490 156TH ST, CHIPPEWA FALLS, WI 54729-1425
(715) 726-3590
Mailing address
2661 COUNTY HIGHWAY I, CHIPPEWA FALLS, WI 54729-5407
(715) 726-3590
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42788000
—
WI
Enumeration date
04/02/2008
Last updated
04/02/2008
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