Basic Information
| Provider Information | |||||||||
| NPI: | 1073956405 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOEME | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | NJ | ||||||||
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| Credential: | MS, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2875 FISH HATCHERY RD | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537133114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082046242 | ||||||||
| FaxNumber: | 6082046249 | ||||||||
| Practice Location | |||||||||
| Address1: | 2875 FISH HATCHERY RD | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537133114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082046242 | ||||||||
| FaxNumber: | 6082046249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2013 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 5051 | WI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.