Provider Demographics
NPI:1659815785
Name:STEEGE, LISA (BCBA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:STEEGE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BELMONT TER
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1436
Mailing Address - Country:US
Mailing Address - Phone:207-222-2172
Mailing Address - Fax:
Practice Address - Street 1:60 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1840
Practice Address - Country:US
Practice Address - Phone:207-494-7304
Practice Address - Fax:207-689-9674
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst