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Individual
LISSA MILTON TREASURE
Active
Individual
LISSA MILTON TREASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6167
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500754037
—
OR
Enumeration date
10/09/2018
Last updated
07/06/2021
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