Individual
LISA DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 HIGHWAY VV, KENNETT, MO 63857
(573) 888-5925
(573) 888-6958
Mailing address
103 S MAIN ST, KENNETT, MO 63857-3039
(573) 888-5925
(573) 888-6958
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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