Individual
LISA M BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3858
AZ
103TA0400X
Addiction (Substance Use Disorder) Psychologist
3858
AZ
103TB0200X
Cognitive & Behavioral Psychologist
3858
AZ
103TC0700X
Clinical Psychologist
3858
AZ
103TF0200X
Forensic Psychologist
3858
AZ
103TH0100X
Health Service Psychologist
3858
AZ
103TR0400X
Rehabilitation Psychologist
3858
AZ
Other
Enumeration date
03/21/2007
Last updated
04/07/2008
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