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General NPI Number Information
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NPI Number | 1790866366
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Entity Type | Individual
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Provider Name | LISA A. DAY PHD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 180 1ST ST W
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City | KETCHUM
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State | ID
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Zip | 83340-0100
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Country | US
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Telephone | 208-720-9342
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Fax | 208-726-6467
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Provider Business Mailing Address
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Address Line | PO BOX 4975
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City | HAILEY
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State | ID
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Zip | 83333-4975
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Country | US
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Telephone | 208-720-9342
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Fax | 208-726-6467
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY202748
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License Number State | ID
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