Liz Bottomley, MA-CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Rush City, MN
NPI 1497981336 · NPPES record last updated Sep 23, 2009
Key facts
- NPI
- 1497981336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5566 (MN)
- Practice address
- 47998 Cedarcrest TRL
Rush City, MN 55069-2564 - Phone
- (320) 358-3682
- NPI assigned
- Jun 5, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5566 | MN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5566 | MN | Yes |
Addresses
Primary practice location
47998 Cedarcrest TRL
Rush City, MN 55069-2564
Mailing address
6448 Main St
P.O. Box 214
North Branch, MN 55056-7068
Phone (651) 277-2543
NPI Registry JSON
{
"created_epoch": "1244160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253664000000",
"number": "1497981336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6448 MAIN ST",
"address_2": "P.O. BOX 214",
"city": "NORTH BRANCH",
"state": "MN",
"postal_code": "550567068",
"telephone_number": "651-277-2543",
"fax_number": "651-277-2544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47998 CEDARCREST TRL",
"city": "RUSH CITY",
"state": "MN",
"postal_code": "550692564",
"telephone_number": "320-358-3682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTTOMLEY",
"first_name": "LIZ",
"credential": "MA-CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-05",
"last_updated": "2009-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "5566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rush City, MN
- Marianne Therese Anderson
- Nicholas Anglo
- Carolyn Marie Bannatyne
- Mary Beckman
- Peter Berg
- Shanna Jean Christian
- Amanda Cowan
- Dragonfly Children'S Respite Home Inc.
- Gretchen Ann Erickson
- Estates at Rush City LLC
All providers in Rush City, MN · Speech-Language Pathologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2009. 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.