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General NPI Number Information
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NPI Number | 1437268638
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Entity Type | Individual
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Provider Name | LISA WATT PHD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2927 N 7TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85013-4102
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Country | US
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Telephone | 602-406-5864
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Fax | 602-406-3030
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Provider Business Mailing Address
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Address Line | 3200 N CENTRAL AVE SUITE 900
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City | PHOENIX
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State | AZ
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Zip | 85012-2425
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Country | US
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Telephone | 602-406-3729
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Fax | 602-798-9412
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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 | 3696
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License Number State | AZ
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