Doctor Name: | DR. LISA ORANSOFF |
NPI Number: | 1629048988 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 001505 |
Business Practice Address: | 161 Mashamnquet Rd Pomfret Center, CT - 06259 |
Business Phone Number: | 8609285904 |
Business Fax Number: | 8609280634 |
Mailing Address: | Po Box 191, POMFRET CENTER |
State: | CT |
Postal Code: | 062590191 |
Phone Number: | 8609285904 |
Fax Number: | 8609280634 |
NPI Enumeration Date: | 01/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 001505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |