| Doctor Name: | LISA ANN CLOUTIER |
| NPI Number: | 1003868092 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 001734 |
| Business Practice Address: | 59 Rainbow Rd Suite 22d East Granby, CT - 060269763 |
| Business Phone Number: | 8606531724 |
| Business Fax Number: | 8606531732 |
| Mailing Address: | 4 Brownstone Rd, EAST GRANBY |
| State: | CT |
| Postal Code: | 060269705 |
| Phone Number: | 8606519159 |
| Fax Number: | |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 04/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0807X |
| License Number: | 001734 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |