| NPI | 1255946976 |
|---|---|
| Former Name | LISA KALIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 049533) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 13566) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |