| NPI | 1578854295 |
|---|---|
| Other Name | LISA S LIVELY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3717) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 0003992) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2023-09-07 |