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General NPI Number Information
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NPI Number | 1730589375
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Entity Type | Organization
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Legal Business Name | LISA S. SOSIN, PH.D.
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 4823 OLD BOONSBORO RD
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City | LYNCHBURG
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State | VA
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Zip | 24503-1825
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Country | US
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Telephone | 248-872-2824
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Fax |
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Provider Business Mailing Address
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Address Line | 4823 OLD BOONSBORO RD
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City | LYNCHBURG
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State | VA
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Zip | 24503-1825
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Country | US
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Telephone | 248-872-2824
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | DR. LISA S SOSIN
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Credential | PH.D., L.P.C., L.L.P
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Telephone | 248-872-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0701004439
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License Number State | VA
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