| NPI | 1194333401 |
|---|---|
| Former Name | LISA MONDORO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701007236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LPCC8418) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2024-01-21 |