Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY9109 | FL |
Y | 103G00000X | Clinical Psychologist | PY9109 | FL |
Y | 103TC0700X | Clinical Psychologist | PY9109 | FL |
N | 103TF0200X | Forensic Psychologist | PY9109 | FL |
NPI | 1023368644 |
---|---|
Provider Name | Dr. Lisa Beth Smalheiser |
First Address | Jupiter, FL 33458-4811 |
Second Address | Jupiter, FL 33458-4811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2012 |
Last Update Date | 25/01/2021 |