Organization
ELIZABETH ANN LEEBERG, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH ANN LEEBERG PH.D. (PRESIDENT)
(541) 318-7023
Entity
Organization
Contact information
Practice address
223 SE DAVIS AVE, BEND, OR 97702-1333
(541) 318-7023
(541) 318-0252
Mailing address
223 SE DAVIS AVE, BEND, OR 97702-1333
(541) 318-7023
(541) 318-0252
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1048
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619075876
NPI
OR
Enumeration date
04/19/2013
Last updated
04/19/2013
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