Organization
ELIZABETH ANN LEEBERG, PH.D., P.C.
Active
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
Update your record
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