| Doctor Name: | MS. LISA FREEMAN MARCINIAK |
| NPI Number: | 1306944145 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA |
| License Number: | |
| Business Practice Address: | 3000 41st Street Ocean Marathon, FL - 330502373 |
| Business Phone Number: | 3054349063 |
| Business Fax Number: | 3054349040 |
| Mailing Address: | 3000 41st Street Ocean, MARATHON |
| State: | FL |
| Postal Code: | 330502373 |
| Phone Number: | 3054349063 |
| Fax Number: | 3054349040 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |