Individual
MS. LISA ANN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCAC, CADAC II,
Contact information
Practice address
1904 W ROYALE DR, MUNCIE, IN 47304-2264
(765) 284-0043
Mailing address
2881 S PRIESTFORD RD, YORKTOWN, IN 47396-9726
(765) 730-5258
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87001300A
IN
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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