Gwendolyn Dacup Lisle
NPI #1265028773 in Lacey, Washington
Provider Information
- NPI Number
- 1265028773
- Entity Type
- Individual
- Name
- Gwendolyn Dacup Lisle
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Dec 18, 2020
- Last Updated
- Dec 18, 2020
Practice Location
- Address
- 8282 28TH CT NE STE A
- City
- Lacey
- State
- Washington
- ZIP Code
- 98516-7162
- Phone
- (360) 915-6868
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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