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General NPI Number Information
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NPI Number | 1851545305
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Entity Type | Organization
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Legal Business Name | LISA R QUERY PHD LCP PLLC
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 11/11/2008
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Provider Practice Location Address
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Address Line | 501 PRINCE GEORGE ST STE 206
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3664
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Country | US
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Telephone | 757-784-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 501 PRINCE GEORGE ST STE 206
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3664
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Country | US
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Telephone | 757-784-1422
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | LISA R QUERY
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Credential | PHD
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Telephone | 757-784-1422
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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 | 0810004015
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License Number State | VA
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