Individual
LISA MARIE WOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, HSPP
Contact information
Practice address
2860 NORTHPARK AVE, HUNTINGTON, IN 46750-9700
(260) 356-2875
(260) 358-0611
Mailing address
850 N HARRISON ST, WARSAW, IN 46580-3163
(574) 267-7169
(574) 268-2377
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041473A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200235550A
—
IN
Enumeration date
10/27/2005
Last updated
12/20/2010
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