Individual
MR. DOUGLAS LIETZKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
1446 FARMINGTON AVE, SUITE 104, POTTSTOWN, PA 19464-1892
(610) 323-8844
(610) 987-0276
Mailing address
1446 FARMINGTON AVE, SUITE 104, POTTSTOWN, PA 19464-1892
(610) 323-8844
(610) 987-0276
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS000394L
PA
Other
Enumeration date
05/28/2006
Last updated
07/08/2007
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