1033103171 NPI number — DR. LISA MARIE FRENCH PSYD

Table of content: DR. LISA MARIE FRENCH PSYD (NPI 1033103171)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033103171 NPI number — DR. LISA MARIE FRENCH PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRENCH
Provider First Name:
LISA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033103171
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 7 BOX 654
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09104-0654
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
492451993378
Provider Business Mailing Address Fax Number:
492451993381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PSC 7
Provider Second Line Business Practice Location Address:
UNIT 8030
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09104-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
492451993378
Provider Business Practice Location Address Fax Number:
492451993381
Provider Enumeration Date:
09/05/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  B1-0000712 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)