Individual
JOANN W LISKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW SAC CCS
Contact information
Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
39123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39123
LICENSE #
WI
05
—
39625700
—
WI
Enumeration date
10/12/2006
Last updated
02/04/2011
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