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Individual

DR. ELISE EGERTER LEONARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4212 N. 16TH ST., PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1637
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1637

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
24161
AZ
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
24161
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
946634
AZ
01
AZ0787300
BCBS
AZ
Enumeration date
10/03/2006
Last updated
09/29/2010
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