Individual
ELIZABETH HAVERSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2906 HIGHWAY AVE, HIGHLAND, IN 46322-1631
(219) 513-8311
(708) 479-2112
Mailing address
2906 HIGHWAY AVE, HIGHLAND, IN 46322-1631
(219) 513-8311
(708) 479-2112
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146005797
IL
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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