Organization
LISA B STORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA B STORY PHD (CLINICAL PSYCHOLOGIST)
(678) 237-1827
Entity
Organization
Contact information
Practice address
4343 SHALLOWFORD RD STE E1, MARIETTA, GA 30062-5056
(678) 237-1827
(888) 975-1953
Mailing address
3777 SWEAT CREEK RUN, MARIETTA, GA 30062-1182
(678) 237-1827
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12193610
CAQH
—
Enumeration date
05/28/2020
Last updated
05/28/2020
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