Individual
DR. LISA BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1024 8TH ST, GREELEY, CO 80631-1101
(970) 330-7696
(970) 330-7696
Mailing address
1024 8TH ST, GREELEY, CO 80631-1101
(970) 330-7696
(970) 330-7696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1496
CO
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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