Individual
LASHUNE GAIL LILLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5430 NW 4TH ST, OCALA, FL 34482-5589
(352) 484-6064
Mailing address
5430 NW 4TH ST, OCALA, FL 34482-5589
(352) 484-6064
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000730300
—
FL
Enumeration date
11/23/2010
Last updated
11/23/2010
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