Provider Demographics
NPI:1023679081
Name:DANBURY, ELIZABETH ZANKEL
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ZANKEL
Last Name:DANBURY
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 1:2111 E BASELINE RD STE C3
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1521
Mailing Address - Country:US
Mailing Address - Phone:928-202-2801
Mailing Address - Fax:
Practice Address - Street 1:2111 E BASELINE RD STE C3
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1521
Practice Address - Country:US
Practice Address - Phone:928-202-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YM0800X
101YM0800X
AZLAC-17512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health