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Individual

LISA VAN DE WATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSW

Contact information

Practice address
996 W 800 S, PAYSON, UT 84651-2766
(801) 465-5111
Mailing address
996 W 800 S, PAYSON, UT 84651-2766

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
09/04/2019
Last updated
09/04/2019
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