Provider Demographics
NPI:1992590418
Name:CAGLE-QUERFELD, LISA MICHELE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELE
Last Name:CAGLE-QUERFELD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MICHELE
Other - Last Name:CAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 BINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-8926
Mailing Address - Country:US
Mailing Address - Phone:727-459-8371
Mailing Address - Fax:517-938-5948
Practice Address - Street 1:119 BINGHAM DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-8926
Practice Address - Country:US
Practice Address - Phone:727-459-8371
Practice Address - Fax:517-938-5948
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling