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NPI Code Detail

MEDICARE: LISA PRESTON

MEDICARE: LISA PRESTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist3361FL

General Provider Information

NPI Number : 1710576020
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA PRESTON
Provider Business Mailing Address
First Line : 1570 CHESTNUT CT W
Second Line :
City : PALM HARBOR
State : FL
Zip : 34683-2115
Country : US
Telephone Number : 858-883-1158
Fax Number :
Provider Business Practice Location Address
First Line : 1570 CHESTNUT CT W
Second Line :
City : PALM HARBOR
State : FL
Zip : 34683-2115
Country : US
Telephone Number : 858-883-1158
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2021
Last Update Date : 01/12/2021

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Directions to “ LISA PRESTON ” Practice Location

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