Individual
LISA MARIE LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2224 W. LAWRENCE AVE., CHICAGO, IL 60625
(312) 636-6109
Mailing address
2224 W LAWRENCE AVE, CHICAGO, IL 60625
(312) 636-6109
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7018392646
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/30/2019
Last updated
06/27/2023
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