Doctor Name: | MS. LISA A WORDEN |
NPI Number: | 1093152886 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 687 S Taft Ave Mason City, IA - 504011532 |
Business Phone Number: | 6412107708 |
Business Fax Number: | |
Mailing Address: | 687 S Taft Ave, MASON CITY |
State: | IA |
Postal Code: | 504011532 |
Phone Number: | 6412107708 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2013 |
NPI Last Update Date: | 06/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |