Provider Demographics
NPI:1871182675
Name:KNUDSEN, LISBETH
Entity Type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-0355
Mailing Address - Country:US
Mailing Address - Phone:402-494-3337
Mailing Address - Fax:402-494-3356
Practice Address - Street 1:1201 ARBOR DR
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-6877
Practice Address - Country:US
Practice Address - Phone:402-494-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker