Provider Demographics
NPI:1972054245
Name:PURPERO, ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:PURPERO
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 1:207 PARKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1439
Mailing Address - Country:US
Mailing Address - Phone:608-692-2164
Mailing Address - Fax:
Practice Address - Street 1:207 PARKVIEW LN
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1439
Practice Address - Country:US
Practice Address - Phone:608-692-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health