| NPI | 1255751590 |
|---|---|
| Former Name | LISA MARIE RISELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005793) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-8346) |
| 106H00000X Marriage & Family Therapist (Licence: ID LMFT-8348) | |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717001312) | |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2022-09-09 |