Individual
MS. LISA JANINE HAJEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 442-4159
Mailing address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 442-4159
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
724-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43596000
—
WI
Enumeration date
08/13/2006
Last updated
11/23/2011
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