Provider Demographics
NPI:1548321771
Name:KIEFFER, ELISABETH (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:
Last Name:KIEFFER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6681 DABNEY ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1151
Mailing Address - Country:US
Mailing Address - Phone:239-292-3710
Mailing Address - Fax:239-931-6039
Practice Address - Street 1:6681 DABNEY ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1151
Practice Address - Country:US
Practice Address - Phone:239-292-3710
Practice Address - Fax:239-931-6039
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL763727600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist