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DAVID LISAK PHD

Forensic

Placitas, New Mexico

Provider NPI: 1629562269

Provider Information:
 DAVID  LISAK PHD
Gender: M
Sole Proprietor


Practice Location:
42 AGUA SARCA RD  PLACITAS, NM 87043 US
Tel: 617-947-4119  Fax: --

Business Mailing Address:
42 AGUA SARCA RD  PLACITAS, NM 87043 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TF0200XBehavioral Health & Social Service Providers
Psychologist
Forensic
MA6295









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