Provider Demographics
NPI:1861383663
Name:LOUIS, ELIZABETH G
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:G
Last Name:LOUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 DELIGHT DR
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-5469
Mailing Address - Country:US
Mailing Address - Phone:772-621-0713
Mailing Address - Fax:
Practice Address - Street 1:5519 DELIGHT DR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-5469
Practice Address - Country:US
Practice Address - Phone:772-621-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency