Provider Demographics
NPI:1750795795
Name:DRUMB, LISA ANN (PHD, BCBA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:DRUMB
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16352 BRIGHAM LN
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-0440
Mailing Address - Country:US
Mailing Address - Phone:812-239-0108
Mailing Address - Fax:
Practice Address - Street 1:16352 BRIGHAM LN
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-0440
Practice Address - Country:US
Practice Address - Phone:812-239-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300057758Medicaid
MA110026265EMedicaid