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1558386797
LISA D MEDLOCK
FORT SMITH, AR
NPI
1558386797
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2006-07-12
Last Update Date
2007-07-08
Business Address
MS. LISA D MEDLOCK MHPP
3111 S 70TH ST
FORT SMITH, AR 72903-5017
Phone number: 479-452-6650
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Mailing Address
MS. LISA D MEDLOCK MHPP
3111 S 70TH ST
FORT SMITH, AR 72903-5017
Phone number: 479-452-6650
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