MEDICARE: MRS. ELIZABETH JITSUKO SCHUBERT

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

General Provider Information

NPI Number	:	1942475801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH JITSUKO SCHUBERT

Provider Business Mailing Address
First Line	:	5831 E 74TH AVE
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-1325
Country	:	US
Telephone Number	:	303-853-3599
Fax Number	:

Provider Business Practice Location Address
First Line	:	5831 E 74TH AVE
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80022-1325
Country	:	US
Telephone Number	:	303-853-3599
Fax Number	:

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

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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