Provider Demographics
NPI:1568110708
Name:LOREE, LISA DIONNE (PHD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:DIONNE
Last Name:LOREE
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 1:7759 N SILVERBELL RD APT 20206
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7219
Mailing Address - Country:US
Mailing Address - Phone:928-699-8894
Mailing Address - Fax:
Practice Address - Street 1:7759 N SILVERBELL RD APT 20206
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7219
Practice Address - Country:US
Practice Address - Phone:928-699-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005485103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical