Doctor Name: | ELIZABETH SLY |
NPI Number: | 1427423888 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 64297 |
Business Practice Address: | 6012 Reef Point Ln Suite C Fort Worth, TX - 761357008 |
Business Phone Number: | 6823128184 |
Business Fax Number: | |
Mailing Address: | 3725 Bill Hickock Rd, Apt 1111 ROANOKE |
State: | TX |
Postal Code: | 762625859 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/09/2015 |
NPI Last Update Date: | 12/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 64297 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |