Provider Demographics
NPI:1326542366
Name:STIGLITZ, ELOISE ANN (PHD)
Entity Type:Individual
Prefix:
First Name:ELOISE
Middle Name:ANN
Last Name:STIGLITZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 LEE RD STE A
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1862
Mailing Address - Country:US
Mailing Address - Phone:407-644-7593
Mailing Address - Fax:407-209-2389
Practice Address - Street 1:2100 LEE RD STE A
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1862
Practice Address - Country:US
Practice Address - Phone:407-644-7593
Practice Address - Fax:407-209-2389
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10123103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist