Individual
MS. CHRISMARTHE TISMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, LNC, CFN
Contact information
Practice address
12411 NW MCGREGOR LN, PORT ST LUCIE, FL 34987-3056
(561) 541-7972
Mailing address
12411 NW MCGREGOR LN, PORT ST LUCIE, FL 34987-3056
(561) 541-7972
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881383517
—
FL
Enumeration date
06/13/2022
Last updated
06/13/2022
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