Provider Demographics
NPI:1104176643
Name:DUMMAR, ELIZABETH MARLOWE
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARLOWE
Last Name:DUMMAR
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 1:58 E 1ST N
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1505
Mailing Address - Country:US
Mailing Address - Phone:208-709-0434
Mailing Address - Fax:208-269-1550
Practice Address - Street 1:58 E 1ST N
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1505
Practice Address - Country:US
Practice Address - Phone:208-709-0434
Practice Address - Fax:208-269-1550
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker