Individual
LISA KIMBERLY LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LISW
Contact information
Practice address
2800 EASTERN AVE, DAVENPORT, IA 52803-2012
(563) 445-0557
Mailing address
2634 GLENN ST, BETTENDORF, IA 52722-3824
(510) 295-8405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007754
IA
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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