Doctor Name: | MS. LISA GAYLORD |
NPI Number: | 1669629150 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BHT |
License Number: | |
Business Practice Address: | 924 N Country Club Dr Mesa, AZ - 852014108 |
Business Phone Number: | 4806963800 |
Business Fax Number: | |
Mailing Address: | 924 N Country Club Dr, MESA |
State: | AZ |
Postal Code: | 852014108 |
Phone Number: | 4806963800 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2008 |
NPI Last Update Date: | 08/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |