Provider Demographics
NPI:1275923427
Name:PFEIFFENBERGER, ELIZABETH AMY
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:AMY
Last Name:PFEIFFENBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:AMY
Other - Last Name:STARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18521 E QUEEN CREEK RD STE 105-627
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5870
Mailing Address - Country:US
Mailing Address - Phone:480-361-1025
Mailing Address - Fax:480-814-7488
Practice Address - Street 1:18521 E QUEEN CREEK RD STE 105-627
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5870
Practice Address - Country:US
Practice Address - Phone:480-361-1025
Practice Address - Fax:480-814-7488
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-16867103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst