Duran, Elisa

Duran, Elisa is an individual health care provider with primary practice located at 5480 W Campbell Ave , Phoenix AZ 85031-1115. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Duran, Elisa can be contacted via phone (623) 691-5119.

Contact Information

Primary practice address
5480 W Campbell Ave Phoenix AZ 85031-1115
Phone: (623) 691-5119
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1790817856
LBN Legal business name Duran, Elisa
Credentials ED.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790817856 NPPES
Arizona MEDICAID 118373

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