| NPI | 1306382007 |
|---|---|
| Former Name | LISA JO DINGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 3266) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302394) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2024-05-02 |