Individual
LISA MICHELLE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 CLEVELAND RD, BOYCE, LA 71409-9284
(318) 793-5221
Mailing address
327 ANDREW ST, PINEVILLE, LA 71360
(318) 448-8756
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6963
LA
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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