MEDICARE: LISA LOEWINGER CLOYD PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4976	NC

General Provider Information

NPI Number	:	1871529636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LOEWINGER CLOYD PH.D.

Provider Business Mailing Address
First Line	:	8693 FORESTER LN
Second Line	:
City	:	APEX
State	:	NC
Zip	:	27539-7933
Country	:	US
Telephone Number	:	919-924-1668
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 NW MAYNARD RD STE 140
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-8707
Country	:	US
Telephone Number	:	919-924-1668
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	12/30/2020

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