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Lisa Renee Dull

Peer Specialist in Longview, WA. Individual provider (NPI-1).

NPI number1982166690
StatusActive
Last updated in NPPESMar 13, 2020

Details

NPI
1982166690
Entity type
Individual (NPI-1)
Name
Lisa Renee Dull
Sex
Female
Sole proprietor
No
Enumeration date
Apr 2, 2019
Certification date
Mar 13, 2020
Last updated
Mar 13, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer Specialist––Yes
171M00000X Case Manager/Care Coordinator––

Practice location

748 14th Ave
Longview, WA 98632-2315

Phone 360-200-5419

Mailing address

748 14th Ave
Longview, WA 98632-2315

Phone 360-200-5419

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