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General NPI Number Information
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NPI Number | 1922981307
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Entity Type | Individual
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Provider Name | LISSETH LONDON
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 93 BERRY HILL DR
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-3967
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Country | US
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Telephone | 210-998-1542
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S MAIN ST STE 600
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City | KALISPELL
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State | MT
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Zip | 59901-1498
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Country | US
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Telephone | 210-998-1542
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P02176
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License Number State | NC
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