Provider Demographics
NPI:1588897540
Name:BOBBY, LISA MARIE (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:BOBBY
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:HUYBRECHTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M A, LMFT
Mailing Address - Street 1:100 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4916
Mailing Address - Country:US
Mailing Address - Phone:720-208-6806
Mailing Address - Fax:
Practice Address - Street 1:100 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4916
Practice Address - Country:US
Practice Address - Phone:720-208-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO881106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist