Provider Demographics
NPI:1427385251
Name:GEORGE, ELIZABETH L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:L
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 AURORA AVE
Mailing Address - Street 2:SUITE 18
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2250
Mailing Address - Country:US
Mailing Address - Phone:303-916-2036
Mailing Address - Fax:
Practice Address - Street 1:2885 AURORA AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2250
Practice Address - Country:US
Practice Address - Phone:303-916-2036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2364103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist