Individual
LYDIA ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
8548 JADE ROAD, KINGDOM CITY, MO 65262
(573) 642-5345
Mailing address
PO BOX 59, KINGDOM CITY, MO 65262-0059
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780821850
—
MO
Enumeration date
06/25/2010
Last updated
06/25/2010
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