LISA JANE WAGONER

LAKE VILLAGE, AR
NPI1386903771
Former NameLISA JANE SNOW
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2012-05-07
Last Update Date2012-05-07
Business Address
-- LISA JANE WAGONER MHPP
316 MAIN ST
LAKE VILLAGE, AR 71653-1942
Phone number: 870-265-2186
Mailing Address
-- LISA JANE WAGONER MHPP
316 MAIN ST
LAKE VILLAGE, AR 71653-1942
Phone number: 870-265-2186
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