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MICHELLE BLAIR LISAC, LCSW

>> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1972989556

Individual Registrant:
 MICHELLE  BLAIR LISAC, LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
13395 N MARANA MAIN ST  MARANA, AZ 85653-7008 US
Tel: 520-682-4111  Fax: --

Contact information for business:
PO BOX 2  SAHUARITA, AZ 85629-0002 US
Tel: --  Fax: --

Registration Information:
NPI: 1972989556
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N104100000XBehavioral Health & Social Service Providers
Social Worker
AZLMSW-18034
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
AZLCSW-19404
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
AZLISAC-15140

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AZ - Page 1



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