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NPI Code Detail

MEDICARE: LISA YOUNG-WEBB ED.S.

MEDICARE:   LISA  YOUNG-WEBB  ED.S.
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
1103TS0200XSchool Psychologist222639CO

General Provider Information

NPI Number : 1508520784
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA YOUNG-WEBB ED.S.
Provider Business Mailing Address
First Line : 2938 WILD CHERRY LN
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-1489
Country : US
Telephone Number : 719-213-6891
Fax Number :
Provider Business Practice Location Address
First Line : 2938 WILD CHERRY LN
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-1489
Country : US
Telephone Number : 719-213-6891
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2021
Last Update Date : 10/25/2021

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Directions to “ LISA YOUNG-WEBB ED.S.” Practice Location

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