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General NPI Number Information
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NPI Number | 1861414757
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Entity Type | Individual
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Provider Name | BETTY JO EHLERT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 SANDTREE DR SUITE 202 D
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1597
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Country | US
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Telephone | 561-691-1808
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Fax | 561-691-1983
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Provider Business Mailing Address
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Address Line | 10423 153RD CT N
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City | JUPITER
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State | FL
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Zip | 33478-6819
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Country | US
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Telephone | 561-745-3149
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 4147
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License Number State | FL
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