Provider Demographics
NPI:1780133801
Name:QUERY, LISA R (PHD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:QUERY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 PRINCE GEORGE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3664
Mailing Address - Country:US
Mailing Address - Phone:757-784-1422
Mailing Address - Fax:757-819-0537
Practice Address - Street 1:501 PRINCE GEORGE ST
Practice Address - Street 2:SUITE 206
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3664
Practice Address - Country:US
Practice Address - Phone:757-784-1422
Practice Address - Fax:757-819-0537
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810004015103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical