Provider Demographics
NPI:1053055400
Name:FIELD, ELIZABETH (LSSP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-3543
Mailing Address - Country:US
Mailing Address - Phone:903-737-7494
Mailing Address - Fax:903-783-1030
Practice Address - Street 1:3280 GRAHAM ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3543
Practice Address - Country:US
Practice Address - Phone:903-737-7494
Practice Address - Fax:903-783-1030
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70203103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool