Provider Demographics
NPI:1225401334
Name:KINSLEY, LISA (MS, CGC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KINSLEY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E SUPERIOR ST
Mailing Address - Street 2:TARRY 13-729
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3010
Mailing Address - Country:US
Mailing Address - Phone:312-503-0154
Mailing Address - Fax:
Practice Address - Street 1:300 E SUPERIOR ST
Practice Address - Street 2:TARRY 13-729
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3010
Practice Address - Country:US
Practice Address - Phone:312-503-0154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS