Individual
LISA GILL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
(870) 862-7921
(870) 864-2490
Mailing address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
(870) 862-7921
(870) 864-2490
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0207030
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W975
BLUE CROSS
AZ
Enumeration date
03/14/2006
Last updated
07/08/2007
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