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General NPI Number Information
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NPI Number | 1659848752
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Entity Type | Organization
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Legal Business Name | DR. LYZ, LLC
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Dates
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Enumeration Date | 10/26/2018
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 15 E. WALNUT ST.
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City | NAZARETH
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State | PA
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Zip | 18064-2708
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Country | US
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Telephone | 610-365-5042
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Fax | 610-365-5044
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Provider Business Mailing Address
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Address Line | 15 E. WALNUT ST.
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City | NAZARETH
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State | PA
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Zip | 18064-2708
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Country | US
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Telephone | 610-365-5042
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Fax | 610-365-5044
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. ELIZABETH DEBOER KREIDER
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Credential | PH.D
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Telephone | 610-365-5042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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