| Doctor Name: | DR. LISA B STORY |
| NPI Number: | 1013091982 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 3178 |
| Business Practice Address: | 4343 Shallowford Rd Suite E1 Marietta, GA - 300625023 |
| Business Phone Number: | 6782371827 |
| Business Fax Number: | 6788681808 |
| Mailing Address: | 4343 Shallowford Rd, Suite E1 MARIETTA |
| State: | GA |
| Postal Code: | 300625023 |
| Phone Number: | 6782371827 |
| Fax Number: | 6788681808 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 05/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 3178 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |