Organization
HARALD W LETTNER PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARALD WOLFGANG LETTNER PHD (OWNER)
(239) 434-6111
Entity
Organization
Contact information
Practice address
501 GOODLETTE RD N, STE. C 104, NAPLES, FL 34102-5661
(239) 434-6111
(239) 649-0472
Mailing address
501 GOODLETTE RD N, STE. C 104, NAPLES, FL 34102-5661
(239) 434-6111
(239) 649-0472
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY4878
FL
103TC0700X
Clinical Psychologist
PY4878
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59545
BLUE CROSS BLUE SHIELD ID
FL
01
—
PY4878
LICENSE NUMBER
FL
Enumeration date
10/03/2006
Last updated
02/18/2015
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