Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elizabeth Provencio

Individual provider Speech-Language Pathologist · NPI 1457182214

Elizabeth Provencio is a Speech-Language Pathologist in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2024
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4554 Laclede Ave Apt 308
Saint Louis, MO 63108-2147
Phone: (217) 553-1786
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP6047 (AZ)

Record details

NPI number1457182214
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 12, 2024
Last updated in NPPESAugust 12, 2024
Certification dateAugust 12, 2024

Other providers in Saint Louis