Individual
DAVID LISAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
42 AGUA SARCA RD, PLACITAS, NM 87043-9404
(617) 947-4119
Mailing address
42 AGUA SARCA RD, PLACITAS, NM 87043-9404
Taxonomy
Speciality
Code
Description
License number
State
103TF0200X
Forensic Psychologist
Primary
6295
MA
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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