Individual
LISA MAE AUTREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
1321 N ASH ST, SPOKANE, WA 99201-2803
(509) 327-3120
Mailing address
1321 N ASH ST, SPOKANE, WA 99201-2803
(095) 327-3120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60520812
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336615848
—
WA
Enumeration date
10/04/2018
Last updated
10/18/2024
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