Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 44SC05292300 | NJ |
Y | 1041C0700X | Clinical Social Worker | LCSW-12863 | AZ |
NPI | 1003018649 |
---|---|
Provider Name | Elizabeth A Hartung |
First Address | Tucson, AZ 85741-2373 |
Second Address | Tucson, AZ 85741-2373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 01/11/2016 |