Lisa Christine Brown, LLP

Individual provider Active NPI Clinical Psychologist · Kingsford, MI

NPI 1497786255 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497786255
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
6301011688 (MI)
Practice address
715 Pyle Dr
Kingsford, MI 49802-4456
Phone
(906) 774-0522
Fax
(906) 774-1570
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6301011688MIMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301011688 MI Yes

Addresses

Primary practice location

715 Pyle Dr
Kingsford, MI 49802-4456

Mailing address

715 Pyle Dr
Kingsford, MI 49802-4456
Phone (906) 774-0522

Other identifiers

IdentifierTypeStateIssuer
982471034362OtherPREFERRED ONE
LB011688OtherMIBCBS OF MI

Other providers in Kingsford, MI

All providers in Kingsford, MI · Clinical Psychologist in Michigan

Sources for this page

Verify at the official NPI Registry.