Provider Demographics
NPI:1023770286
Name:COTTLE, ELIZABETH ANNA (MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNA
Last Name:COTTLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 W GURLEY ST
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-3613
Mailing Address - Country:US
Mailing Address - Phone:928-458-9473
Mailing Address - Fax:
Practice Address - Street 1:819 W GURLEY ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-3613
Practice Address - Country:US
Practice Address - Phone:928-458-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional