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NPI Code Detail

MEDICARE: LISA GUY PHD

MEDICARE: LISA GUY PHD
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 PsychologistPSY001794GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588745814
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA GUY PHD
Provider Business Mailing Address
First Line : 2931 E BIDDLE ST
Second Line : PATIENT ACCOUNTING
City : BALTIMORE
State : MD
Zip : 21213-3939
Country : US
Telephone Number : 443-923-1886
Fax Number : 443-923-1875
Provider Business Practice Location Address
First Line : 1920 BRIARCLIFF RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-4010
Country : US
Telephone Number : 404-419-4000
Fax Number : 404-419-4505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/29/2021

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Directions to “ LISA GUY PHD” Practice Location

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