Provider Demographics
NPI:1720038870
Name:DAY, ELIZABETH MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MARY
Last Name:DAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MARY
Other - Last Name:HERBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:475 REED RD STE 104
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-6307
Mailing Address - Country:US
Mailing Address - Phone:706-529-8710
Mailing Address - Fax:706-529-8715
Practice Address - Street 1:475 REED RD STE 104
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-6307
Practice Address - Country:US
Practice Address - Phone:706-529-8710
Practice Address - Fax:706-529-8715
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002191103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00791546BMedicaid
S62836Medicare UPIN
GA00791546BMedicaid