Individual
LISA A. DULAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
31 MAIN STREET, GRAY, ME 04039
(207) 657-7101
(207) 657-7165
Mailing address
94 AUBURN ST, SUITE 106, PORTLAND, ME 04103-2141
(207) 878-3003
(207) 878-3004
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
296
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098721
ANTHEM BCBS OF CA
CA
01
—
098721
OUT OF NETWORK (ANTHEM)
ME
01
—
200119
ANTHEM BLUE CROSS BLUE SHIELD
ME
Enumeration date
05/02/2007
Last updated
12/05/2008
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