Basic Information
Provider Information
NPI: 1659939973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOYMAN
FirstName: LISA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 492 LINDBERGH PL NE APT 1302
Address2:  
City: ATLANTA
State: GA
PostalCode: 303243315
CountryCode: US
TelephoneNumber: 3032507074
FaxNumber:  
Practice Location
Address1: 495 COOPER RD STE 212
Address2:  
City: WESTERVILLE
State: OH
PostalCode: 430818735
CountryCode: US
TelephoneNumber: 6148822581
FaxNumber: 6148826097
Other Information
ProviderEnumerationDate: 06/01/2019
LastUpdateDate: 03/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY004264GAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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