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MRS. LISA LA'REE KISHIYAMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
660 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5299
(208) 523-1558
(208) 529-4788
Mailing address
2820 SAINT CHARLES AVE, IDAHO FALLS, ID 83404-7330
(208) 681-4808

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LMSW-31426
ID

Other

Enumeration date
06/16/2011
Last updated
06/16/2011
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