Provider Demographics
NPI:1558671719
Name:RAMIREZ, ELIZABETH (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RAMIREZ
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 1:4111 E VALLEY AUTO DR
Mailing Address - Street 2:STE. 201
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4605
Mailing Address - Country:US
Mailing Address - Phone:480-269-4449
Mailing Address - Fax:
Practice Address - Street 1:4111 E VALLEY AUTO DR
Practice Address - Street 2:STE. 201
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4605
Practice Address - Country:US
Practice Address - Phone:480-269-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4131103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist