| NPI | 1356687396 |
|---|---|
| Former Name | LISA ANN NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C9311) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 4520) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2023-03-28 |