Doctor Name: | DR. ELIZABETH LUSBY |
NPI Number: | 1194846253 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 30807 |
Business Practice Address: | 1215 Hall Johnson Road Suite 100 Colleyville, TX - 76034 |
Business Phone Number: | 8174289810 |
Business Fax Number: | 8174289885 |
Mailing Address: | 1215 Hall Johnson Road, Suite 100 COLLEYVILLE |
State: | TX |
Postal Code: | 76034 |
Phone Number: | 8174289810 |
Fax Number: | 8174289885 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 30807 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |