MS. M. Lise Moulton, L.I.S.W.

NPI #1619079886 in Willoughby, Ohio

Provider Information

NPI Number: 1619079886
Entity Type: Individual
Name: MS. M. Lise Moulton, L.I.S.W.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: L.I.S.W.
Enumeration Date: Sep 1, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 5105 SOM CENTER RD
City: Willoughby
State: Ohio
ZIP Code: 44094-4203
Phone: (216) 621-5600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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