NPI | 1124671763 |
---|---|
Former Name | APRIL KAY LISIAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW111480) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LCSW111480) |
104100000X Social Worker (Licence: CA LCSW111480) | |
101Y00000X Counselor (Licence: CA LCSW1114) | |
Enumeration Date | 2019-07-23 |
Last Update Date | 2024-01-26 |