| Doctor Name: | DR. LISA MONETTE TAIT |
| NPI Number: | 1083954192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 007320 |
| Business Practice Address: | 5238 Ashley Dr Sw Lilburn, GA - 300476639 |
| Business Phone Number: | 7703560101 |
| Business Fax Number: | 7709250305 |
| Mailing Address: | 5238 Ashley Dr Sw, LILBURN |
| State: | GA |
| Postal Code: | 300476639 |
| Phone Number: | 7703560101 |
| Fax Number: | 7709250305 |
| NPI Enumeration Date: | 02/26/2013 |
| NPI Last Update Date: | 12/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 007320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |