Individual
DR. M ELIZ DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
10985 N POINSETTIA DR, ORO VALLEY, AZ 85737-6695
(520) 469-7977
Mailing address
10985 N POINSETTIA DR, TUCSON, AZ 85737-6695
(520) 469-7977
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3349
AZ
103TC0700X
Clinical Psychologist
Primary
3349
AZ
103TP2701X
Group Psychotherapy Psychologist
3349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z60681
MEDICARE PART B
AZ
Enumeration date
11/15/2006
Last updated
01/12/2012
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