Individual
MRS. LISA LYNNE AUTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. S.W., A.C.S.W.
Contact information
Practice address
2125 16TH STREET, BEDFORD, IN 47421
(812) 275-4053
Mailing address
4001 ROSEWOOD DRIVE, BLOOMINGTON, IN 47404
(812) 929-2747
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003553A
IN
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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