Individual
SUSAN LISENBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1354 8TH ST SW, ROANOKE, VA 24015-1812
(540) 342-4048
Mailing address
1354 8TH ST SW, ROANOKE, VA 24015-1812
(540) 342-4048
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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