Individual
LISA LEE DERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
1807 N CENTER ST STE 204, BEAVER DAM, WI 53916-1005
(920) 887-8751
Mailing address
104 LAKE SHORE TER, BEAVER DAM, WI 53916-1246
(920) 382-4064
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8363-226
WI
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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