Mary Lisbon

NPI #1194230631 in Odessa, Florida

Provider Information

NPI Number: 1194230631
Entity Type: Individual
Name: Mary Lisbon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Dec 6, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 16414 LAKE CHURCH DR
City: Odessa
State: Florida
ZIP Code: 33556-2637
Phone: (813) 926-5414

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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