Organization
LISA WILLMON LPC-S PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA R WILLMON LPC-S (OWNER)
(512) 333-4040
Entity
Organization
Contact information
Practice address
922 MAIN ST STE C, BASTROP, TX 78602-3810
(512) 333-4040
Mailing address
489 AGNES ST # 408, BASTROP, TX 78602-2156
(512) 333-4040
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/15/2024
Last updated
09/06/2024
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