Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6430 | OH |
Y | 103G00000X | Clinical Psychologist | 6430 | OH |
Y | 103TC0700X | Clinical Psychologist | 6430 | OH |
NPI | 1184020737 |
---|---|
Provider Name | Dr. Lisa Doane |
First Address | Rocky River, OH 44116-3501 |
Second Address | Rocky River, OH 44116-3501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2014 |
Last Update Date | 10/11/2014 |