Individual
LIZA HAROLDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 MEMORIAL DR, CLARKSVILLE, TN 37043-6326
(217) 649-9553
Mailing address
1820 MEMORIAL DR STE 203, CLARKSVILLE, TN 37043-4693
(217) 649-9553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6873
TN
1041C0700X
Clinical Social Worker
8019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100043360
—
WI
05
—
1619219904
—
WI
01
—
K400192662
MEDICARE
WI
Enumeration date
03/25/2013
Last updated
01/26/2023
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