Healthcare Provider Details

I. General information

NPI: 1336078336
Provider Name (Legal Business Name): LISA A PAUL-BRAMER PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 410
TOLEDO OH
43606-1355
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 410
TOLEDO OH
43606-1355
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-5203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KASSIDY KOEPFLER
Title or Position: BILLING MANAGER
Credential:
Phone: 419-461-6152