Individual
MRS. LISA NICOLE GILLISPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1943 PAINT CREEK RD, STANTON, KY 40380-9418
(606) 663-0688
(606) 663-0688
Mailing address
1943 PAINT CREEK RD, STANTON, KY 40380-9418
(606) 663-0688
(606) 663-0688
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
000078761
KY
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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