Individual
ROBERT D. LISOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
725 S WOODRUFF AVE STE 101, IDAHO FALLS, ID 83401-5286
(208) 346-7500
(208) 346-7501
Mailing address
725 S WOODRUFF AVE STE 101, IDAHO FALLS, ID 83401-5286
(208) 346-7500
(208) 346-7501
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY202807
ID
Other
Enumeration date
06/23/2009
Last updated
05/30/2025
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