Provider Demographics
NPI:1497935688
Name:HARTMAN, ELIZABETH M (MA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-1847
Mailing Address - Country:US
Mailing Address - Phone:970-668-3387
Mailing Address - Fax:970-668-3389
Practice Address - Street 1:120 THIRD AVE.
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-3387
Practice Address - Fax:970-668-3389
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional