Provider Information for 1316636327
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Dr. LIA WILLIS Ph.D.
Sex: Female
NPI: 1316636327
Last Updated: 2023-05-04
Certification Date: 2023-05-04
Certification Date: 2023-05-04
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316636327 | ||||||||
| Enumeration Date | 2023-05-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4605 WESTFIELD LN COLUMBIA, MO 65203-6228 United States Phone: 573-818-5351 | Fax: | ||||||||
| Primary Practice Address | 4605 WESTFIELD LN COLUMBIA, MO 65203-6228 United States Phone: 573-818-5351 | Fax: | ||||||||
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