Individual
LISA MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMFT, LPC
Contact information
Practice address
1791 22ND ST, RICE LAKE, WI 54868-8723
(715) 719-0122
Mailing address
1791 22ND ST, RICE LAKE, WI 54868-8723
(715) 719-0122
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2728-125
WI
106H00000X
Marriage & Family Therapist
Primary
566-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39760500
—
WI
Enumeration date
05/13/2007
Last updated
05/13/2008
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