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1831260009
DOUG J LISLE
SANTA ROSA, CA
NPI
1831260009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY15448)
Enumeration Date
2006-11-10
Last Update Date
2008-05-01
Business Address
-- DOUG J LISLE P.H.D.
1551 PACIFIC AVE
SANTA ROSA, CA 95404-3568
Phone number: 707-586-5555
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Mailing Address
-- DOUG J LISLE P.H.D.
1551 PACIFIC AVE
SANTA ROSA, CA 95404-3568
Phone number: 707-586-5555
Copy
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