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Individual

LISA ANTONISHEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
28900 PONTIAC TRL, SOUTH LYON, MI 48178-9241
(734) 929-9703
Mailing address
3830 PACKARD ST, ANN ARBOR, MI 48108-2051
(734) 929-9703

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011115
MI

Other

Enumeration date
02/06/2012
Last updated
01/07/2026
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