MEDICARE: ELIZABETH ZANKEL DANBURY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		AZ
2	101YM0800X	Mental Health Counselor
3	101YM0800X	Mental Health Counselor	LAC-17512	AZ

General Provider Information

NPI Number	:	1023679081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ZANKEL DANBURY

Provider Business Mailing Address
First Line	:	2111 E BASELINE RD STE C3
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1521
Country	:	US
Telephone Number	:	928-202-2801
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 E BASELINE RD STE C3
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1521
Country	:	US
Telephone Number	:	928-202-2801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2019
Last Update Date	:	06/21/2019

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