Individual
LISA WALTRIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
19515 BRUNE PKWY, WARRENTON, MO 63383-6505
(636) 456-1500
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2017041096
MO
Other
Enumeration date
02/26/2018
Last updated
09/30/2019
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