Individual
ELISHEBA DOUGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14765 W MOUNTAIN VIEW BLVD # 107, SURPRISE, AZ 85374-2704
(602) 649-0245
Mailing address
14765 W MOUNTAIN VIEW BLVD # 107, SURPRISE, AZ 85374-2704
(602) 649-0245
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0673
ZZ
106S00000X
Behavior Technician
Primary
0673
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091903
—
AZ
Enumeration date
08/24/2023
Last updated
03/26/2026
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