NPI | 1043359193 |
---|---|
Former Name | LISA FRIEMARK, NIEMAN, NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9434) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801078040) |
101YM0800X Counselor, Mental Health (Licence: MI 6801078040) | |
1041C0700X Social Worker, Clinical (Licence: MI 6801078040) | |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY9434) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY9434) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 010141-2015) | |
Enumeration Date | 2007-02-05 |
Last Update Date | 2015-11-09 |