Provider Demographics
NPI:1922589126
Name:BROWNE, LISA M
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:BROWNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:AURIGEMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3584 E FOX TROTTER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-8334
Mailing Address - Country:US
Mailing Address - Phone:480-785-6811
Mailing Address - Fax:
Practice Address - Street 1:3584 E FOX TROTTER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-8334
Practice Address - Country:US
Practice Address - Phone:480-785-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool