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Individual

LISA K BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1405 RUCKER BLVD, ENTERPRISE, AL 36330-2236
(334) 417-0212
(334) 417-0213
Mailing address
1405 RUCKER BLVD, ENTERPRISE, AL 36330-2236
(334) 417-0212
(334) 417-0213

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
04998
AL
101YP2500X
Professional Counselor
Primary
04998
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001428100
FL
Enumeration date
02/01/2010
Last updated
08/18/2024
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