Provider Demographics
NPI:1326018979
Name:LOMBARDO, ELIZABETH ROESSLER (PHD, MS, PT)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ROESSLER
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PHD, MS, PT
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Mailing Address - Street 1:1000 BROOKTREE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9286
Mailing Address - Country:US
Mailing Address - Phone:214-242-2267
Mailing Address - Fax:214-242-2267
Practice Address - Street 1:1000 BROOKTREE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9286
Practice Address - Country:US
Practice Address - Phone:214-242-2267
Practice Address - Fax:214-242-2267
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2010-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPS016582103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610938Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST