Individual
MR. JUDSON LISIECKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
153 SUMMER ST, PROVIDENCE, RI 02903-4011
(401) 276-4334
(401) 331-3285
Mailing address
153 SUMMER ST, PROVIDENCE, RI 02903-4011
(401) 276-4334
(401) 331-3285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01877
RI
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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