Healthcare Provider Details

I. General information

NPI: 1194848051
Provider Name (Legal Business Name): LISA HUNTER LOLLAR PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 LOGAN ST SUITE 203
DENVER CO
80203-3130
US

IV. Provider business mailing address

899 LOGAN ST SUITE 203
DENVER CO
80203-3130
US

V. Phone/Fax

Practice location:
  • Phone: 303-831-4288
  • Fax: 303-831-4286
Mailing address:
  • Phone: 303-831-4288
  • Fax: 303-831-4286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1993
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: