Most Relevant Information
Provider Data
| NPI Number: | 1003196775 |
| Provider Name: | LISA JEAN MEREDITH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/25/2011 |
| Last Updated: | 08/25/2011 |
Provider Practice Location
1215 SW G ST
GRANTS PASS
OR
975262544
Practice Location Phone/Fax
| Phone: | 5414762373 |
| Fax: | 5414761526 |
Provider Mailing Location
1215 SW G ST
GRANTS PASS
OR
975262544
Provider Mailing Phone/Fax
| Phone: | 5414762373 |
| Fax: | 5414761526 |