Booan, Lisa Jane

Booan, Lisa Jane is an individual health care provider with primary practice located at 5901 Plantation Cir , Roanoke VA 24019-4937. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Booan, Lisa Jane can be contacted via phone (540) 561-8175.

Contact Information

Primary practice address
5901 Plantation Cir Roanoke VA 24019-4937
Phone: (540) 561-8175
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 0813001187 Virginia

Profile Details

NPI number 1043971856
LBN Legal business name Booan, Lisa Jane
Credentials M.ED, ED.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2022
Last updated Jan 4th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043971856 NPPES
Virginia Other 0813001187 STATE LICENSE LIMITED

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