Provider Demographics
NPI:1306075973
Name:CURTIN, LISA A (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:CURTIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 DEER XING
Mailing Address - Street 2:
Mailing Address - City:TODD
Mailing Address - State:NC
Mailing Address - Zip Code:28684-9059
Mailing Address - Country:US
Mailing Address - Phone:828-297-6469
Mailing Address - Fax:
Practice Address - Street 1:222 DEER XING
Practice Address - Street 2:
Practice Address - City:TODD
Practice Address - State:NC
Practice Address - Zip Code:28684-9059
Practice Address - Country:US
Practice Address - Phone:828-297-6469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-04
Last Update Date:2009-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2690103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045HROtherBLUECROSS BLUESHIELD OF NORTH CAROLINA