Individual
DR. LISA ANN CUSEO-OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
12129 GRAHAM MEADOWS DR, RICHMOND, VA 23233-6661
(804) 288-4084
(804) 282-2601
Mailing address
7130 GLEN FOREST DR, SUITE 101, RICHMOND, VA 23226-3754
(804) 288-4084
(804) 282-8678
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001927
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073531299
—
VA
Enumeration date
07/17/2006
Last updated
04/23/2018
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