Provider Information for 1518608595
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ELIZABETH ANN THIEL MS, MEd
Other Names:Former Name:ELIZABETH ANN POLLEY MS, MEdSex: Female
NPI: 1518608595
Last Updated: 2022-12-09
Certification Date: 2022-11-28
Certification Date: 2022-11-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518608595 | ||||||||
| Enumeration Date | 2022-04-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 10738 PLEASANT KNOLL DR TAMPA, FL 33647-3667 United States Phone: 614-743-1054 | Fax: | ||||||||
| Primary Practice Address | 10738 PLEASANT KNOLL DR TAMPA, FL 33647-3667 United States Phone: 614-743-1054 | Fax: | ||||||||
| Secondary Practice Address(es) | 7070 SCARLET OAK DR | ||||||||
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