Individual
MR. JEFFERY C LISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
501 N 12TH ST, STE.1, CENTERVILLE, IA 52544-1439
(641) 856-2688
(641) 856-2690
Mailing address
501 N 12TH ST, STE.1, CENTERVILLE, IA 52544-1439
(641) 856-2688
(641) 856-2690
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
05587
IA
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/15/2014
Last updated
04/29/2014
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