Individual
LISA K LAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4313
Mailing address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4313
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000134
VT
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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