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Individual

DR. LISA ANNA SPANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D., BCBA-D

Contact information

Practice address
35 CLYDE RD, SUITE 101, SOMERSET, NJ 08873-5033
(732) 873-1212
Mailing address
15 GATES PLACE, WAYNE, NJ 07470
(201) 694-4998

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-05-2397
NJ
103TC0700X
Clinical Psychologist
083-957
NJ

Other

Enumeration date
01/14/2009
Last updated
06/15/2021
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