Provider Demographics
NPI:1144032590
Name:PALECEK, LISA JANE (IHP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JANE
Last Name:PALECEK
Suffix:
Gender:F
Credentials:IHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W6800 COUNTY ROAD Z
Mailing Address - Street 2:
Mailing Address - City:MONDOVI
Mailing Address - State:WI
Mailing Address - Zip Code:54755-8581
Mailing Address - Country:US
Mailing Address - Phone:507-205-3639
Mailing Address - Fax:
Practice Address - Street 1:W6800 COUNTY ROAD Z
Practice Address - Street 2:
Practice Address - City:MONDOVI
Practice Address - State:WI
Practice Address - Zip Code:54755-8581
Practice Address - Country:US
Practice Address - Phone:507-205-3639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1231158033171400000X
WI175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness Coach