Provider Demographics
NPI:1538394473
Name:WITCHER, LISA ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:WITCHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3576
Mailing Address - Country:US
Mailing Address - Phone:502-554-3345
Mailing Address - Fax:
Practice Address - Street 1:9045 HOLLY ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3576
Practice Address - Country:US
Practice Address - Phone:502-554-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program