Individual
MS. LISA A OBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.P.
Contact information
Practice address
11 CENTURY HILL DRIVE, SUITE 206, LATHAM, NY 12110-2151
(518) 713-4595
(518) 713-4598
Mailing address
11 CENTURY HILL DRIVE, LATHAM, NY 12110-2151
(518) 713-4595
(518) 713-4595
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401070
NY
Other
Enumeration date
07/20/2007
Last updated
01/04/2012
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