Individual
AMY LISICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 N LA BREA AVE, INGLEWOOD, CA 90302-3049
(323) 294-4932
Mailing address
925 CENTINELA AVE APT 5, INGLEWOOD, CA 90302-1579
(310) 988-6179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14560
CA
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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