Individual
MRS. LISA ANN LILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 E SOUTH ST, TAHLEQUAH, OK 74464-4024
(918) 931-0225
Mailing address
PO BOX 641, TAHLEQUAH, OK 74465-0641
(918) 931-0225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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