Individual
ANGIE ELIZANDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
15678 COQUINA DR, MONUMENT, CO 80132-6018
(501) 551-0613
(800) 551-9389
Mailing address
15678 COQUINA DR, MONUMENT, CO 80132-6018
(501) 551-0613
(800) 551-9389
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11-19P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180346795
—
AR
Enumeration date
01/15/2010
Last updated
02/11/2020
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