Provider Demographics
NPI:1023103488
Name:DAVIES, ELISABETH GAYLE (MC)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:GAYLE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9401 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE #183 AND SUITE #186
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4233
Mailing Address - Country:US
Mailing Address - Phone:623-583-2893
Mailing Address - Fax:623-376-9282
Practice Address - Street 1:9401 W THUNDERBIRD RD
Practice Address - Street 2:SUITE #183 AND SUITE #186
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4233
Practice Address - Country:US
Practice Address - Phone:623-583-2893
Practice Address - Fax:623-376-9282
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health