| NPI | 1700397726 |
|---|---|
| Former Name | NICOLE ANISE LISBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP135529) |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2022-05-31 |