Individual
LISA HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPP
Contact information
Practice address
1212 ASHLEY CIR STE 3, BOWLING GREEN, KY 42104-5821
(270) 842-0029
(270) 782-8875
Mailing address
1212 ASHLEY CIR STE 3, BOWLING GREEN, KY 42104-5821
(270) 842-0029
(270) 782-8875
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
KY-0096
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
08/13/2006
Last updated
06/18/2012
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