Individual
MARIA JOSE LISOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 BROOKLINE PL STE 502, BROOKLINE, MA 02445-7277
(617) 651-2111
(815) 205-4478
Mailing address
30 N GOULD ST # 42229, SHERIDAN, WY 82801-6317
(617) 651-2111
(815) 205-4478
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD266517
MA
2084P0800X
Psychiatry Physician
MD455655
PA
Other
Enumeration date
08/07/2012
Last updated
05/11/2024
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