Provider Demographics
NPI:1831317262
Name:HOWARD, LISA YOUNGLING (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:YOUNGLING
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 UPPER CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON DEPOT
Mailing Address - State:CT
Mailing Address - Zip Code:06794-1612
Mailing Address - Country:US
Mailing Address - Phone:860-567-4474
Mailing Address - Fax:860-567-4474
Practice Address - Street 1:43 WEST ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3501
Practice Address - Country:US
Practice Address - Phone:860-567-4474
Practice Address - Fax:860-567-4474
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0388942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry