| Doctor Name: | AUDRA D'ELISO |
| NPI Number: | 1225327455 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS LPC |
| License Number: | LPC-15734 |
| Business Practice Address: | 2044 N Recker Rd Mesa, AZ - 852152744 |
| Business Phone Number: | 4807882523 |
| Business Fax Number: | |
| Mailing Address: | 5635 N Scottsdale Rd Ste 170, SCOTTSDALE |
| State: | AZ |
| Postal Code: | 852505945 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2011 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LPC-15734 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |