Individual
LISA ANN MCMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
608 W GLEN ARBOR WAY, BLOOMINGTON, IN 47403-4537
(812) 345-0492
(812) 333-0961
Mailing address
608 W GLEN ARBOR WAY, BLOOMINGTON, IN 47403-4537
(812) 345-0492
(812) 333-4537
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041347A
IN
103TC0700X
Clinical Psychologist
5436
OH
Other
Enumeration date
12/12/2006
Last updated
10/09/2020
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