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General NPI Number Information
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NPI Number | 1861896557
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Entity Type | Organization
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Legal Business Name | LISA D. STINSON, PH.D., LLC
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 109 E 2ND ST SUITE 11
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5474
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Country | US
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Telephone | 308-660-9602
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Fax | 855-710-7722
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Provider Business Mailing Address
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Address Line | 109 E 2ND ST SUITE 11
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5474
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Country | US
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Telephone | 308-660-9602
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Fax | 855-710-7722
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. LISA DIANE STINSON
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Credential | PHD
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Telephone | 308-660-9602
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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 | 858
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License Number State | NE
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