Individual
DR. LISA M. BRENNER
Active
Individual
DR. LISA M. BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY01812
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179641
BLUE CROSS BLUE SHIELD
MO
01
—
2110205
FIRST HEALTH
MO
01
—
216258
COMPSYCH
MO
01
—
338175
MANAGED HEALTH NETWORK
MO
05
—
498577113
—
MO
01
—
628448
HEALTHLINK HMO/PPO
MO
Enumeration date
06/05/2006
Last updated
09/03/2009
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