Individual
TAMARA L LISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACIII
Contact information
Practice address
515 28 3/4 RD, GRAND JUNCTION, CO 81501-5016
(970) 241-2603
Mailing address
515 28 3/4 RD, GRAND JUNCTION, CO 81501-5016
(970) 241-6023
(970) 683-7055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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