Provider Demographics
NPI:1093986325
Name:BUSE, LISA A (MSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:BUSE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 NORTH LAKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:TWIN LAKES
Mailing Address - State:WI
Mailing Address - Zip Code:53181
Mailing Address - Country:US
Mailing Address - Phone:262-877-4446
Mailing Address - Fax:262-877-3574
Practice Address - Street 1:210 NORTH LAKE AVE
Practice Address - Street 2:
Practice Address - City:TWIN LAKES
Practice Address - State:WI
Practice Address - Zip Code:53181
Practice Address - Country:US
Practice Address - Phone:262-877-4446
Practice Address - Fax:262-877-3574
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker