Individual
ELIZABETH BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 W BASELINE RD STE 108, TEMPE, AZ 85283-5349
(623) 282-1646
Mailing address
401 W BASELINE RD STE 108, TEMPE, AZ 85283-5349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18518
AZ
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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