| NPI | 1255753539 |
|---|---|
| Former Name | LISA MARIE BISCHOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001582) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 15067) |
| 101YP2500X Counselor, Professional (Licence: IA 20768) | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2016-09-12 |