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1740550102
LISA A MIXON
UTICA, NY
NPI
1740550102
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TS0200X Psychologist, School
(Licence: NY 2185967)
Enumeration Date
2012-01-03
Last Update Date
2012-01-03
Business Address
-- LISA A MIXON
130 LOMOND CT
UTICA, NY 13502-5951
Phone number: 315-724-4286
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Mailing Address
-- LISA A MIXON
130 LOMOND CT
UTICA, NY 13502-5951
Phone number: 315-724-4286
Copy
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