Individual
LISA CARRIE TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6602 121ST ST NW, GIG HARBOR, WA 98332-8611
(253) 857-4742
(253) 857-4742
Mailing address
6602 121ST ST NW, GIG HARBOR, WA 98332-8611
(253) 857-4742
(253) 857-4742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00007113
WA
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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