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1053819953
LISA PACKARD
PORT ORANGE, FL
NPI
1053819953
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW13499)
Enumeration Date
2018-01-25
Last Update Date
2018-03-17
Business Address
LISA PACKARD
906 WINGATE TRL
PORT ORANGE, FL 32128-7524
Phone number: 989-262-9905
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Mailing Address
LISA PACKARD
906 WINGATE TRL
PORT ORANGE, FL 32128-7524
Phone number: 989-262-9905
Copy
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