Individual
DR. LISA L. MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 240, PEORIA, IL 61615-9541
(309) 683-5006
(309) 683-5095
Mailing address
8600 N STATE ROUTE 91, SUITE 240, PEORIA, IL 61615-9541
(309) 683-5006
(309) 683-5095
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079195
HEALTH ALLIANCE
IL
Enumeration date
06/29/2006
Last updated
05/04/2016
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