Provider Demographics
NPI:1689874117
Name:HERRMANN, LISA MARIE (MS, CMHS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:MS, CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 N DISCOVERY PL
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1566
Mailing Address - Country:US
Mailing Address - Phone:509-747-4174
Mailing Address - Fax:509-838-3847
Practice Address - Street 1:2323 N DISCOVERY PL
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1566
Practice Address - Country:US
Practice Address - Phone:509-747-4174
Practice Address - Fax:509-838-3847
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health