Individual
DR. ELIZABETH ANN EARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4568 S HIGHLAND DR STE 270, SALT LAKE CITY, UT 84117
(801) 478-2780
(801) 478-2781
Mailing address
9891 BORG DR, SANDY, UT 84092-4120
(801) 403-4631
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
377440-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37744025001001
BLUE CROSS BLUE SHIELD
UT
01
—
680012550
RAILROAD MEDICARE
UT
01
—
R13268
STERLING
UT
Enumeration date
10/26/2005
Last updated
08/13/2018
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