| NPI | 1063700144 |
|---|---|
| Former Name | LISA ANN REITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 2053) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 7249) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2015-09-10 |