Individual
DAVID REED LYSAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5900 BOND AVE, CENTREVILLE, IL 62207-2326
(619) 332-5302
(618) 332-5285
Mailing address
5900 BOND AVE, CENTREVILLE, IL 62207-2326
(619) 332-5302
(618) 332-5285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149009090
IL
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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