Provider Demographics
NPI:1932641487
Name:PRITCHARD, ELIZABETH GAIL
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GAIL
Last Name:PRITCHARD
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 1:5894 GLORY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1281
Mailing Address - Country:US
Mailing Address - Phone:310-480-6694
Mailing Address - Fax:
Practice Address - Street 1:5894 GLORY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1281
Practice Address - Country:US
Practice Address - Phone:310-480-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health