Provider Demographics
NPI:1669897633
Name:DINGUS, ELIZABETH (MS, NCSP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DINGUS
Suffix:
Gender:F
Credentials:MS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LIVERPOOL HTS
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9811
Mailing Address - Country:US
Mailing Address - Phone:585-880-0403
Mailing Address - Fax:
Practice Address - Street 1:16 LIVERPOOL HTS
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-9811
Practice Address - Country:US
Practice Address - Phone:585-880-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1335377103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool