Individual
MS. LISA SUZANNE HIXENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR-BC, LPC
Contact information
Practice address
6122 RIDGE AVE, PHILADELPHIA, PA 19128-1603
(215) 487-1330
(215) 487-1641
Mailing address
643 W KINGSLEY ST, PHILADELPHIA, PA 19144-3707
(215) 848-7716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PC004316
PA
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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