Individual
TABITHA N. LISOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7666
Mailing address
514 RIVERVIEW AVE, WAUKESHA, WI 53188-3631
(262) 548-7666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21167-130
WI
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/20/2023
Last updated
06/12/2026
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