Provider Demographics
NPI:1073671152
Name:WECHSLER, LISA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:S
Last Name:WECHSLER
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 1:17304 PRESTON RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5618
Mailing Address - Country:US
Mailing Address - Phone:214-438-3838
Mailing Address - Fax:972-733-6809
Practice Address - Street 1:17304 PRESTON RD
Practice Address - Street 2:SUITE 800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5618
Practice Address - Country:US
Practice Address - Phone:214-438-3838
Practice Address - Fax:972-733-6809
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14663103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling