Individual
DR. LISA MARLETTE COTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
975 PORT WASHINGTON RD, AURORA MEDICAL CENTER - GRAFTON, SUITE 410, GRAFTON, WI 53024-9201
(262) 329-4305
(262) 329-5614
Mailing address
975 PORT WASHINGTON RD, AURORA MEDICAL CENTER - GRAFTON, SUITE 410, GRAFTON, WI 53024-9201
(262) 329-4305
(262) 329-5614
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2815-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43734900
—
WI
Enumeration date
04/15/2008
Last updated
12/13/2021
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