Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY7083 | FL |
Y | 103TC0700X | Clinical Psychologist | PY7083 | FL |
N | 103TC1900X | Counseling Psychologist | PY 7083 | FL |
N | 103TF0200X | Forensic Psychologist | PY7083 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY7083 | FL |
NPI | 1154376994 |
---|---|
Provider Name | Dr. Elizabeth Letsch |
First Address | Tampa, FL 33612-4745 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 27/01/2009 |