Most Relevant Information
Provider Data
| NPI Number: | 1003009408 |
| Provider Name: | LISA WYNLAND LUKIANOFF |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2007 |
| Last Updated: | 08/20/2007 |
Provider Practice Location
555 NORTHGATE DR
FAMILY SERVICE AGENCY OF MARIN
SAN RAFAEL
CA
949033680
Practice Location Phone/Fax
| Phone: | 4154915700 |
| Fax: |
Provider Mailing Location
PO BOX 513
FOREST KNOLLS
CA
949330513
Provider Mailing Phone/Fax
| Phone: | 4154888802 |
| Fax: |