| Name: | Lisa S. Gonzenbach, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 02 Apr 2013 (12 years ago) |
| Date of dissolution: | 22 Apr 2022 |
| Entity Number: | 000-276-836 |
| Register Number: | 000276836 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | 3600 WATERMELON ROAD SUITE 202NORTHPORT, AL 35473 |
| Principal Address ZIP Code: | 35473 |
Activities
PSYCHOTHERAPY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861828519 | 2013-09-25 | 2014-01-23 | 3600 WATERMELON RD, SUITE 202, NORTHPORT, AL, 354735169, US | 3600 WATERMELON RD, SUITE 202, NORTHPORT, AL, 354735169, US | |||||||||||||||||
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| Phone | +1 205-750-0181 |
Authorized person
| Name | LISA GONZENBACH |
| Role | OWNER |
| Phone | 2057500181 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | 0969C |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GONZENBACH, LISA S | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
