Lisa Lanelle Wyly CADC II

NPI 1770610040 - Counselor - 101YA0400X

NPI Details
NPI 1770610040
Gender Female
Enumeration Date 02/27/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2731 NUGGET AVE
LAKE ISABELLA CA, 93240, US
Phone (760) 379-3412
Fax (760) 379-5332
Business Location
6625 LAUREL AVENUE
PO BOX 568
LAKE ISABELLA CA, 93204, US
Phone (760) 379-3412
Fax (760) 379-5332
Toxanomy
Taxonomy Code 101YA0400X
License State California
License Number C8528805
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According to our database, Mrs. Lisa Lanelle Wyly CADC II NPI is 1770610040, taxonomy code is 101YA0400X and license number is C8528805, license state is located at California. Lisa Lanelle Wyly CADC II physically located at 2731 Nugget Ave, Lake Isabella CA, 93240. NPI Number Lisa Lanelle Wyly CADC II has the Individual type.

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1770610040 NPI number is provided on an as is basis without warranty of any kind. 1770610040 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Lanelle Wyly CADC II are for informational purposes only.