Healthcare Provider Details

I. General information

NPI: 1285043281
Provider Name (Legal Business Name): LINDSAY LISKOWIAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 RIVERHILL RD
COLUMBUS OH
43221-1235
US

IV. Provider business mailing address

2133 RIVERHILL RD
COLUMBUS OH
43221-1235
US

V. Phone/Fax

Practice location:
  • Phone: 614-314-5682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3053577
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: