Individual
LISI CHRISTINE GRULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CD, CBE, LE
Contact information
Practice address
15400 SW 134TH PL APT 408, MIAMI, FL 33177-8121
(786) 380-8887
Mailing address
15400 SW 134TH PL APT 408, MIAMI, FL 33177-8121
(786) 380-8887
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831510684
—
FL
Enumeration date
09/19/2023
Last updated
09/26/2023
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