Provider Demographics
NPI:1295967024
Name:HARKER, LISA A (PSYD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:HARKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:ZAKARIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:3N-14
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6069
Mailing Address - Fax:314-454-4013
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:3N-14
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6069
Practice Address - Fax:314-454-4013
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014606103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist