Fedewa, Lisa

Fedewa, Lisa is an individual health care provider with primary practice located at 259 Bill France Blvd Suite 200, Daytona Beach FL 32114-1316. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Fedewa, Lisa can be contacted via phone (904) 586-6560.

Contact Information

Primary practice address
259 Bill France Blvd Suite 200 Daytona Beach FL 32114-1316
Phone: (904) 586-6560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1265776454
LBN Legal business name Fedewa, Lisa
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2012
Last updated Aug 5th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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