Individual
LISA NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFCS-HDFS
Contact information
Practice address
2112 MAIDEN LANE SW, ROANOKE, VA 24015
(540) 293-7516
Mailing address
2112 MAIDEN LN SW, ROANOKE, VA 24015-2208
(540) 293-7516
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
VA
Other
Enumeration date
08/27/2017
Last updated
07/21/2022
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