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Individual

LISA DAWN BOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPP

Contact information

Practice address
161 PROSPEROUS PL, LEXINGTON, KY 40509-1898
(859) 368-0609
(859) 368-9767
Mailing address
161 PROSPEROUS PL, LEXINGTON, KY 40509-1898
(859) 368-0609
(859) 368-9767

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
0905
KY
103TC0700X
Clinical Psychologist
Primary
175264
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000689151
ANTHEM BCBS
05
30610026
KY
Enumeration date
07/08/2008
Last updated
03/17/2018
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