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1578796488
STEPHANIE LISIUS
SANTA ROSA, CA
NPI
1578796488
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA L0701091027)
Enumeration Date
2009-08-25
Last Update Date
2009-08-25
Business Address
-- STEPHANIE LISIUS
3315 AIRWAY DR
SANTA ROSA, CA 95403-2005
Phone number: 707-523-2242
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Mailing Address
-- STEPHANIE LISIUS
3315 AIRWAY DR
SANTA ROSA, CA 95403-2005
Phone number: 707-523-2242
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