Individual
DR. LISA JEANNE BRANDYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD.
Contact information
Practice address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1842
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000631
—
NC
Enumeration date
08/01/2006
Last updated
09/06/2023
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