De Lissovoy, Victoria
De Lissovoy, Victoria is an sole proprietor health care provider with primary practice located at 1109 Bryn Mawr Ave , Lake Wales FL 33853-4333. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. De Lissovoy, Victoria can be contacted via phone (863) 605-1865.Contact Information
Primary practice address
1109 Bryn Mawr Ave
Lake Wales FL 33853-4333
Phone: (863) 605-1865
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW6807 | Florida |
Profile Details
| NPI number | 1639124100 |
|---|---|
| LBN Legal business name | De Lissovoy, Victoria |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jun 4th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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