Provider Demographics
NPI:1114911567
Name:STIRLING, ELIZABETH COLE (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:COLE
Last Name:STIRLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:STIRLING COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87504-1267
Mailing Address - Country:US
Mailing Address - Phone:505-983-1583
Mailing Address - Fax:505-989-1748
Practice Address - Street 1:1063 GOVERNOR DEMPSEY DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1045
Practice Address - Country:US
Practice Address - Phone:505-983-1583
Practice Address - Fax:505-989-1748
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM59082Medicaid