Provider Demographics
NPI:1508403007
Name:ERNHART, ELIZABETH MARGUERITE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARGUERITE
Last Name:ERNHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 YANCY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW GERMANY
Mailing Address - State:MN
Mailing Address - Zip Code:55367-9319
Mailing Address - Country:US
Mailing Address - Phone:612-760-1662
Mailing Address - Fax:
Practice Address - Street 1:3910 YANCY AVE
Practice Address - Street 2:
Practice Address - City:NEW GERMANY
Practice Address - State:MN
Practice Address - Zip Code:55367-9319
Practice Address - Country:US
Practice Address - Phone:612-760-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician