Individual
JENNIFER LISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9 CEDAR ST, WORCESTER, MA 01609-2505
(508) 210-0114
(508) 755-8645
Mailing address
15 AVERY RD, HOLDEN, MA 01520-1235
(508) 210-0114
(508) 755-8645
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7335
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1854062
—
MA
Enumeration date
12/23/2006
Last updated
07/08/2007
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