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General NPI Number Information
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NPI Number | 1427376847
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Entity Type | Individual
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Provider Name | LISA A TALBOT PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 525 PLYMOUTH RD SUITE 308
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1640
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Country | US
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Telephone | 610-825-9400
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Fax | 610-825-7130
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Provider Business Mailing Address
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Address Line | 236 DAVID DR
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City | HAVERTOWN
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State | PA
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Zip | 19083-1020
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Country | US
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Telephone | 610-924-0971
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Fax | 610-664-7682
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS00888IL
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License Number State | PA
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