Individual
MS. LISA M DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
1606 WELLINGTON AVE UNIT C, WILMINGTON, NC 28401-7704
(910) 799-4505
Mailing address
PO BOX 601, STONEVILLE, NC 27048-0601
(336) 627-1514
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5390
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103376
—
NC
Enumeration date
12/08/2006
Last updated
10/18/2012
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