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NPI Code Detail

MEDICARE: LISA MARIE JOBAY LPC, R-DMT

MEDICARE: LISA MARIE JOBAY LPC, R-DMT
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
1101YM0800XMental Health CounselorC5758OR

General Provider Information

NPI Number : 1952853442
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE JOBAY LPC, R-DMT
Provider Business Mailing Address
First Line : 61843 DOBBIN RD
Second Line :
City : BEND
State : OR
Zip : 97702-9536
Country : US
Telephone Number : 458-206-0337
Fax Number :
Provider Business Practice Location Address
First Line : 60575 BILLADEAU RD
Second Line :
City : BEND
State : OR
Zip : 97702-9338
Country : US
Telephone Number : 541-382-9410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2016
Last Update Date : 09/04/2024

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