Organization
MITCHELL C. LISS, PSY.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL CRAIG LISS PSY.D. (PSYCHOLOGIST)
(215) 869-8195
Entity
Organization
Contact information
Practice address
1101 KINGS HWY N STE 313, CHERRY HILL, NJ 08034
(215) 869-8195
Mailing address
1101 KINGS HWY N STE 313, CHERRY HILL, NJ 08034-1912
(215) 869-8195
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235592320
NPI
NJ
Enumeration date
06/18/2018
Last updated
12/10/2024
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