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Individual

MRS. LISA DIANE NIEMISTO

Active
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Individual

MRS. LISA DIANE NIEMISTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C02843
MI
101YM0800X
Mental Health Counselor
6801095909
MI
1041C0700X
Clinical Social Worker
Primary
6801095909
MI

Other

Enumeration date
12/19/2013
Last updated
11/04/2020
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