Individual
LISA LILLARD OGLESBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, PHD
Contact information
Practice address
1111 N NORTHSHORE DR STE S490, KNOXVILLE, TN 37919-2808
(865) 584-0171
(865) 584-0174
Mailing address
1111 N NORTHSHORE DR STE S490, KNOXVILLE, TN 37919-2808
(865) 584-0171
(865) 584-0174
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P2740
TN
225100000X
Physical Therapist
PT764
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3646591
—
TN
05
—
36465911
—
TN
Enumeration date
07/12/2005
Last updated
01/18/2019
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