Individual
ELIZABETH S MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
905 W GOVERNOR RD STE 200, HERSHEY, PA 17033-2310
(717) 531-7235
(717) 531-0067
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PS018864
PA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS018864
PA
103TF0000X
Family Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285628552
AGENCIES
NY
Enumeration date
09/13/2016
Last updated
10/03/2019
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