| NPI | 1477705978 |
|---|---|
| Former Name | LISA M NACKOVIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 1470) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2022-02-17 |