| NPI | 1194986588 |
|---|---|
| Former Name | LISA JO WEBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 660124) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1054) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2009-06-02 |