Provider Information for 1649725359
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
LISA MALHAM LPC
Sex: Female
NPI: 1649725359
Last Updated: 2016-08-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1649725359 | ||||||||
| Enumeration Date | 2016-08-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3341 YOUREE DR STE 101 SHREVEPORT, LA 71105-2125 United States Phone: 318-219-4167 | Fax:318-219-4834 | ||||||||
| Primary Practice Address | 3341 YOUREE DR STE 101 SHREVEPORT, LA 71105-2125 United States Phone: 318-219-4167 | Fax:318-219-4834 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|