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Individual

DR. LISA R BLACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
314 MDOS/ SGOH, 1090 ARNOLD DRIVE, LITTLE ROCK AFB, AR 72099-0001
(501) 987-7338
(501) 987-8087
Mailing address
314 MDOS/ SGOH, 1090 ARNOLD DRIVE, LITTLE ROCK AFB, AR 72099
(501) 987-7338
(501) 987-8087

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Enumeration date
08/18/2005
Last updated
09/17/2007
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