Individual
MISS LISA MARIE WYSOCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8930 EMPERORS CT, INDIANAPOLIS, IN 46234-9599
(316) 271-9356
(317) 271-7347
Mailing address
8930 EMPERORS CT, INDIANAPOLIS, IN 46234-9599
(316) 271-9356
(317) 271-7347
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
533007
IN
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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