Provider Demographics
NPI:1740334861
Name:YUFIT, LISA RACHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:RACHAEL
Last Name:YUFIT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26111 W 14 MILE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1168
Mailing Address - Country:US
Mailing Address - Phone:248-626-4622
Mailing Address - Fax:248-626-2908
Practice Address - Street 1:26111 W 14 MILE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:FRANKLIN
Practice Address - State:MI
Practice Address - Zip Code:48025-1168
Practice Address - Country:US
Practice Address - Phone:248-626-4622
Practice Address - Fax:248-626-2908
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical