Individual
LISA D MCGRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7400 HIGHWAY N, O FALLON, MO 63368-7013
(636) 561-7080
Mailing address
7400 HIGHWAY N, O FALLON, MO 63368-7013
(636) 561-7080
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2001000880
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495366924
—
MO
Enumeration date
12/11/2008
Last updated
12/11/2008
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