Doctor Name: | DR. LISA MARIE PUMA |
NPI Number: | 1114095296 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 2415 |
Business Practice Address: | 4371 E 72nd Ave Commerce City, CO - 800221471 |
Business Phone Number: | 3038533685 |
Business Fax Number: | 3032896962 |
Mailing Address: | 4371 E 72nd Ave, COMMERCE CITY |
State: | CO |
Postal Code: | 800221471 |
Phone Number: | 3038533685 |
Fax Number: | 3032896962 |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |