Most Relevant Information
Provider Data
| NPI Number: | 1003678624 |
| Provider Name: | LISA LYNN BALDERSTONE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | ISW17277 |
Most Important Dates
| Enumeration Date: | 01/29/2024 |
| Last Updated: | 01/29/2024 |
Provider Practice Location
5331 COMMERCIAL WAY STE 209
SPRING HILL
FL
346061426
Practice Location Phone/Fax
| Phone: | 3525150000 |
| Fax: | 3525565729 |
Provider Mailing Location
3986 BRAMBLEWOOD LOOP
SPRING HILL
FL
346090664
Provider Mailing Phone/Fax
| Phone: | 9894829858 |
| Fax: | 3525565729 |