Individual
MS. LISA RENEE DORLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S, LSW
Contact information
Practice address
130 1ST ST NW, MASSILLON, OH 44647
(330) 833-0234
(330) 837-7705
Mailing address
625 CLEVELAND AVE NW, CANTON, OH 44702-1805
(330) 455-0374
(330) 453-6716
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E.0002909
OH
104100000X
Social Worker
S.0018185
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242555
—
OH
Enumeration date
10/01/2008
Last updated
08/01/2018
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