Healthcare Provider Details

I. General information

NPI: 1699830471
Provider Name (Legal Business Name): LISA A. TEEGARDEN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRAMC, DEPT OF PSYCHOLOGY, BLDG 6, 3RD FLOOR 6900 GEORGIA AVE, N.W.
WASHINGTON DC
20307-5001
US

IV. Provider business mailing address

2 WRAMC ROOM 2J38 6900 GEORGIA AVE. NW
WASHINGTON DC
20307-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-0065
  • Fax: 202-782-7165
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1150
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1150
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: