Doctor Name: | MRS. LISA E GOLIGHTLY |
NPI Number: | 1043514425 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L P C |
License Number: | 19436 |
Business Practice Address: | 1516 Tanglerose Ct Desoto, TX - 751157842 |
Business Phone Number: | 9723655614 |
Business Fax Number: | |
Mailing Address: | 1516 Tanglerose Ct, DESOTO |
State: | TX |
Postal Code: | 751157842 |
Phone Number: | 9723655614 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2010 |
NPI Last Update Date: | 12/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 19436 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |