Provider Demographics
NPI:1902997042
Name:O'LAUGHLIN, ELIZABETH M (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:O'LAUGHLIN
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 1:1610 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-1605
Mailing Address - Country:US
Mailing Address - Phone:812-234-7184
Mailing Address - Fax:
Practice Address - Street 1:INDIANA STATE UNIVERSITY
Practice Address - Street 2:PSYCHOLOGY CLINIC: ROOT HALL
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47809-0001
Practice Address - Country:US
Practice Address - Phone:812-237-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist