Individual
DR. LISA DYAN WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCP
Contact information
Practice address
508 CHEROKEE ST, LEAVENWORTH, KS 66048-2626
(913) 206-8154
(913) 273-4559
Mailing address
13115 W 74TH ST, SHAWNEE, KS 66216-4412
(913) 206-8154
(913) 273-4559
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
932
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609274430
NPPES
KS
01
—
932
LICENSED CLINICAL PSYCHOTHERAPIST
KS
Enumeration date
09/02/2011
Last updated
05/24/2022
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