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Individual
DR. MITCHELL LISS
Active
Individual
DR. MITCHELL LISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
35SI00511900
NJ
103TC0700X
Clinical Psychologist
PS017309
PA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
35SI00511900
NJ
103TC2200X
Clinical Child & Adolescent Psychologist
PS017309
PA
Other
Enumeration date
04/05/2016
Last updated
12/10/2024
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