Provider Demographics
NPI:1487407151
Name:HAURY, ELIZABETH HOPKINS
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HOPKINS
Last Name:HAURY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18344 CLARK ST STE 205
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3575
Mailing Address - Country:US
Mailing Address - Phone:610-999-1305
Mailing Address - Fax:
Practice Address - Street 1:1123 4TH AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3428
Practice Address - Country:US
Practice Address - Phone:610-999-1305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist