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Individual
LISA MARIE GUILLOD
Active
Individual
LISA MARIE GUILLOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
44SC01491100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC01491100
NJ LICENSE
NJ
Enumeration date
12/24/2018
Last updated
06/11/2019
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