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Individual

AMANDA JEAN LISKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14346 MANOR CT, LEAWOOD, KS 66224-3965
(785) 218-4198
Mailing address
14346 MANOR CT, LEAWOOD, KS 66224-3965
(785) 218-4198

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119005444
VA
225X00000X
Occupational Therapist
Primary
113650
TX
225X00000X
Occupational Therapist
OT010000679
DC

Other

Enumeration date
02/25/2013
Last updated
02/25/2013
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