NPI | 1609081025 |
---|---|
Other Name | LISA LEADBETTER EISELE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP4480) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP4480) |
103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN LP4480) | |
Enumeration Date | 2007-05-11 |
Last Update Date | 2007-07-08 |