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1386185031
DAVID LISAK
GRASS VALLEY, CA
NPI
1386185031
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA MRT2525)
Enumeration Date
2017-03-14
Last Update Date
2017-03-14
Business Address
-- DAVID LISAK
256 BUENA VISTA ST
GRASS VALLEY, CA 95945-7239
Phone number: 530-274-2000
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Mailing Address
-- DAVID LISAK
256 BUENA VISTA ST
GRASS VALLEY, CA 95945-7239
Phone number: 530-274-2000
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