| NPI | 1205940327 |
|---|---|
| Other Name | LISSA WHYTE DOUGLASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-07-29 |