Individual
LISA GAIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
14502 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618-2075
(813) 494-7845
Mailing address
14502 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618-2075
(813) 494-7845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY5292
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54577
BLUE CROSS
FL
Enumeration date
03/27/2007
Last updated
03/05/2012
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