Healthcare Provider Details
I. General information
NPI: 1518951334
Provider Name (Legal Business Name): DORIS P LANCASTER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/08/2005
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UNIT 5210 BOX 230
APO AE
09461
US
IV. Provider business mailing address
PSC 41 BOX 6352
APO AE
09464
US
V. Phone/Fax
- Phone: 011441638528124
- Fax: 163-852-8649
- Phone: 011441638528124
- Fax: 163-852-8649
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 2438 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: