Individual
LISA DIANA DOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 KENTUCKY AVE, CUMBERLAND, MD 21502-3838
(304) 707-9331
Mailing address
1312 KENTUCKY AVE, CUMBERLAND, MD 21502-3838
(304) 707-9331
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/08/2023
Last updated
12/08/2023
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