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NPI Code Detail

MEDICARE: DR. LISA MARKLEY LSP

MEDICARE:  DR. LISA  MARKLEY  LSP
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 Psychologist03145OH

General Provider Information

NPI Number : 1740118389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA MARKLEY LSP
Provider Business Mailing Address
First Line : 24647 W 3RD ST
Second Line :
City : GRAND RAPIDS
State : OH
Zip : 43522-9432
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 PARK AVE
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-1455
Country : US
Telephone Number : 419-436-4110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “ DR. LISA MARKLEY LSP” Practice Location

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