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NPI Code Detail

MEDICARE: DR. LISA MARIE PUMA PH.D.

MEDICARE: DR. LISA MARIE PUMA PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist2415CO

General Provider Information

NPI Number : 1114095296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA MARIE PUMA PH.D.
Provider Business Mailing Address
First Line : 4371 E 72ND AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1471
Country : US
Telephone Number : 303-853-3685
Fax Number : 303-289-6962
Provider Business Practice Location Address
First Line : 4371 E 72ND AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-1471
Country : US
Telephone Number : 303-853-3685
Fax Number : 303-289-6962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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