Individual
DR. ELIZA CARLSON LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7004 WISSAHICKON AVE, PHILADELPHIA, PA 19119-3730
(215) 806-7563
Mailing address
7004 WISSAHICKON AVE, PHILADELPHIA, PA 19119-3730
(215) 806-7563
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS017566
PA
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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