| NPI | 1689824054 |
|---|---|
| Former Name | LISA M HALLQUIST HALLQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW018031) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY R069403-1) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2016-03-18 |