Provider Demographics
NPI:1538503594
Name:GOLDMAN, LISA E (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ELEANOR
Other - Last Name:DONALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:WHOLE HUMAN PSYCHIATRY PLLC
Mailing Address - Street 2:3849 E. BROADWAY #260
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716
Mailing Address - Country:US
Mailing Address - Phone:520-235-5259
Mailing Address - Fax:520-369-3939
Practice Address - Street 1:2030 E. BROADWAY #26
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:515-497-0820
Practice Address - Fax:520-369-3939
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN539722084P0800X
AZ518972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry