Individual
LISA HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 S LAKEWOOD DR, EFFINGHAM, IL 62401-1847
(217) 254-3877
Mailing address
6 S LAKEWOOD DR, EFFINGHAM, IL 62401-1847
(217) 254-3877
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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