Individual ProviderLisa Marie DollPsychologistBehavioral Health & Social Service ProvidersPractice Address102 Heritage Way NE, Suite 302, Leesburg, VA 20176-4544(703) 771-5100PECOS EnrollmentThis provider is enrolled in PECOS as LISA DOLL.Based on the most recent information from CMS, provider Lisa Marie Doll is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1114035250Provider TypeIndividualFull NameDoll, Lisa MarieTitleDr.CredentialPSY.D.GenderFemaleSole ProprietorYesEnumeration Date8/28/2006Last Updated9/10/2007Contact InformationPractice LocationPractice Address102 Heritage Way NE, Suite 302, Leesburg, VA 20176-4544Phone(703) 771-5100FaxUnlisted FaxMailing LocationMailing Address102 Heritage Way NE, Suite 302, Leesburg, VA 20176-4544Phone(703) 771-5100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense0810003628Virginia