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Individual

ADAM PETER LISEWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
2933 LAKE JAMES DR APT 202, FUQUAY VARINA, NC 27526-3920
(120) 330-5148

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9390
NC
225XM0800X
Mental Health Occupational Therapist
8086
CO

Other

Enumeration date
09/17/2014
Last updated
07/30/2023
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