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Individual

MRS. LISA MARIE DOUGLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD/LD

Contact information

Practice address
819 N 1ST ST, DENNISON, OH 44621-1003
(740) 922-2800
(740) 922-7483
Mailing address
819 N 1ST ST, DENNISON, OH 44621-1003
(740) 922-2800
(740) 922-7483

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5131
OH

Other

Enumeration date
01/02/2008
Last updated
01/02/2008
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