Individual
TARA LISKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
999 SILVER LN, SUITE 2A, TRUMBULL, CT 06611-5343
(203) 386-0044
(203) 377-4156
Mailing address
999 SILVER LN, SUITE 2A, TRUMBULL, CT 06611-5343
(203) 386-0044
(203) 377-4156
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000358
CT
Other
Enumeration date
08/04/2005
Last updated
07/20/2015
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