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General NPI Number Information
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NPI Number | 1023237658
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Entity Type | Individual
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Provider Name | LISA LANE DAVISSON LPC
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 8105 RASOR BLVD STE 117
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City | PLANO
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State | TX
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Zip | 75024-0118
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Country | US
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Telephone | 214-267-8673
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Fax | 214-279-5198
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Provider Business Mailing Address
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Address Line | 17725 WINDFLOWER WAY UNIT 103
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City | DALLAS
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State | TX
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Zip | 75252-5206
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Country | US
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Telephone | 214-808-4670
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Fax | 214-279-5198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15989
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License Number State | TX
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