Provider Demographics
NPI:1265808281
Name:DEMORET, ELIZABETH L
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:DEMORET
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 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-771-8261
Mailing Address - Fax:501-771-8263
Practice Address - Street 1:3425 N FUTRALL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4811
Practice Address - Country:US
Practice Address - Phone:479-713-8350
Practice Address - Fax:479-332-0701
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7948-C1041C0700X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool