Doctor Name: | MS. LISA SUZANNE HIXENBAUGH |
NPI Number: | 1134351034 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, ATR-BC, LPC |
License Number: | PC004316 |
Business Practice Address: | 6122 Ridge Ave Philadelphia, PA - 191281603 |
Business Phone Number: | 2154871330 |
Business Fax Number: | 2154871641 |
Mailing Address: | 643 W Kingsley St, PHILADELPHIA |
State: | PA |
Postal Code: | 191443707 |
Phone Number: | 2158487716 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2009 |
NPI Last Update Date: | 08/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | PC004316 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |