Provider Demographics
NPI:1477097939
Name:ABELSON-GERTLER, LIZA MALIN (PSYD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:MALIN
Last Name:ABELSON-GERTLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LIZA
Other - Middle Name:MALIN
Other - Last Name:GERTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:19528 POND MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3324
Mailing Address - Country:US
Mailing Address - Phone:541-419-3770
Mailing Address - Fax:
Practice Address - Street 1:131 NW HAWTHORNE AVE
Practice Address - Street 2:STE 112
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2957
Practice Address - Country:US
Practice Address - Phone:541-241-5980
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health