Individual
ELIZABETH MITCHELL STREETE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
P1609
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120517
—
MS
01
—
3094738
BCBS OF TN
TN
05
—
3689381
—
TN
Enumeration date
05/10/2006
Last updated
06/28/2023
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