| NPI | 1346788478 |
|---|---|
| Former Name | LISA FASANELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00725400) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH10327) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2025-01-15 |