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Individual

MRS. LISA MARIE DIALS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCNS

Contact information

Practice address
578 N LEAVITT RD, AMHERST, OH 44001-1131
(440) 989-3801
(440) 988-1227
Mailing address
PO BOX 636643, CINCINNATI, OH 45263-6643
(440) 988-1009
(440) 988-1227

Taxonomy

Speciality
Code
Description
License number
State
364SC0200X
Critical Care Medicine Clinical Nurse Specialist
Primary
COA.13374-NS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082382
OH
05
3025372
OH
Enumeration date
01/03/2013
Last updated
02/05/2016
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