Individual
LISSA DOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 CALDEDON CT B, GREENVILLE, SC 29615-2961
(864) 631-2084
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 361-4000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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