Individual
MRS. LISA LYNN DITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 LOMOND CT, UTICA, NY 13502-5951
(315) 724-4286
(315) 724-4170
Mailing address
6375 GRANDVIEW AVE, ROME, NY 13440-7416
(315) 335-4761
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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