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1639281959
LISA RENAE DOUGLAS
FAYETTEVILLE, AR
NPI
1639281959
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Former Name
LISA RENAE LUNDEEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
170300000X Genetic Counselor, MS
Enumeration Date
2006-08-31
Last Update Date
2007-07-08
Business Address
-- LISA RENAE DOUGLAS MHPP
12 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703-1822
Phone number: 479-750-2020
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Mailing Address
-- LISA RENAE DOUGLAS MHPP
PO BOX 6430
SPRINGDALE, AR 72766-6430
Phone number: 479-750-2020
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