Provider Demographics
NPI:1497842702
Name:HARPER, LISA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:HARPER
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 1:5803 YOUREE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4243
Mailing Address - Country:US
Mailing Address - Phone:318-865-5400
Mailing Address - Fax:318-865-5800
Practice Address - Street 1:5803 YOUREE DR
Practice Address - Street 2:STE 200
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4243
Practice Address - Country:US
Practice Address - Phone:318-865-5400
Practice Address - Fax:318-865-5800
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA656103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T3025DF45Medicare UPIN