Provider Demographics
NPI:1144279829
Name:ASLIN, MARY ELISABETH (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELISABETH
Last Name:ASLIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 KING ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-1337
Mailing Address - Country:US
Mailing Address - Phone:417-466-7455
Mailing Address - Fax:
Practice Address - Street 1:600 N. MAIN
Practice Address - Street 2:MISSOURI REHABILITATION CENTER
Practice Address - City:MOUNT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712
Practice Address - Country:US
Practice Address - Phone:417-461-5323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7235Z00000X
MO2007025047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist