Provider Demographics
NPI:1073052932
Name:WEARY, ELIZABETH D (BA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:WEARY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 LAS PALMAS ENTRADA AVE APT 227
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5605
Mailing Address - Country:US
Mailing Address - Phone:901-208-4668
Mailing Address - Fax:
Practice Address - Street 1:951 LAS PALMAS ENTRADA AVE APT 227
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-5605
Practice Address - Country:US
Practice Address - Phone:901-208-4668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator