Provider Demographics
NPI:1184712523
Name:MISNER, PRISCILLA (LCSW)
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:
Last Name:MISNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 N COUNTRY CLUB RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1651
Mailing Address - Country:US
Mailing Address - Phone:520-326-8424
Mailing Address - Fax:520-326-8669
Practice Address - Street 1:3131 N COUNTRY CLUB RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1651
Practice Address - Country:US
Practice Address - Phone:520-326-8424
Practice Address - Fax:520-326-8669
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW04841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical