Provider Demographics
NPI:1770660326
Name:DAHLMEIER-SOUSA, ELIZABETH A (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:DAHLMEIER-SOUSA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:143 N MCCORMICK ST STE 204
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2726
Mailing Address - Country:US
Mailing Address - Phone:928-445-4301
Mailing Address - Fax:928-771-2437
Practice Address - Street 1:143 N MCCORMICK ST STE 204
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2726
Practice Address - Country:US
Practice Address - Phone:928-445-4301
Practice Address - Fax:928-771-2437
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-0379106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist