| Doctor Name: | DR. LISA MARIE HOLLE |
| NPI Number: | 1609169523 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHARMD |
| License Number: | PCT.0011838 |
| Business Practice Address: | 1232 Storrs Rd #6 Storrs, CT - 062682232 |
| Business Phone Number: | 8606343697 |
| Business Fax Number: | |
| Mailing Address: | 69 N Eagleville Rd, Unit 3092 STORRS |
| State: | CT |
| Postal Code: | 062693092 |
| Phone Number: | 8606343697 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2011 |
| NPI Last Update Date: | 05/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P0018X |
| License Number: | PCT.0011838 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |