Provider Demographics
NPI:1629427778
Name:HARDING, LISA (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HARDING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:472 WHEELERS FARMS RD STE 306
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-9109
Mailing Address - Country:US
Mailing Address - Phone:203-701-9737
Mailing Address - Fax:877-325-2241
Practice Address - Street 1:472 WHEELERS FARMS RD STE 306
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06461-9109
Practice Address - Country:US
Practice Address - Phone:563-676-8923
Practice Address - Fax:859-545-5013
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94-090292084P0800X
CT0640502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry