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General NPI Number Information
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NPI Number | 1144254400
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Entity Type | Individual
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Provider Name | ELYSE C LUBELL PHD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6201 HAMILTON BLVD SUITE 202
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City | ALLENTOWN
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State | PA
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Zip | 18104
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Country | US
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Telephone | 484-553-1252
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Fax | 610-398-1949
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Provider Business Mailing Address
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Address Line | 197 WINDERMERE AVE
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City | ALLENTOWN
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State | PA
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Zip | 18104
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Country | US
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Telephone | 484-553-1252
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Fax | 610-398-1949
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PS015440
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License Number State | PA
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