Elizabeth Bannowsky, M.S. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Aztec, NM
NPI 1063128239 · NPPES record last updated Jan 30, 2023
Key facts
- NPI
- 1063128239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP7963 (NM)
- Practice address
- 901 McCoy Ave
Aztec, NM 87410-1727 - Phone
- (505) 334-6831
- NPI assigned
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP7963 | NM | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP7963 | NM | Yes |
Addresses
Primary practice location
901 McCoy Ave
Aztec, NM 87410-1727
Mailing address
41 Road 3004
Aztec, NM 87410-9504
Other providers in Aztec, NM
- Aztec Municipal School District
- Aztec Municipal Schools
- Aztec Spa and Wellness
- Aztec Urgent Care, LLC
- Rebekah Bainter
- William R Barkman
- Dana Kay Bearden
- Stacey Marie Bentley
- William Beyhan
- Julie Bisbee
All providers in Aztec, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.