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1447798566
LISA ELLISBELLO
SAN RAFAEL, CA
NPI
1447798566
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-02-09
Last Update Date
2017-02-09
Business Address
-- LISA ELLISBELLO
1477 LINCOLN AVE
SAN RAFAEL, CA 94901-2028
Phone number: 415-459-2395
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Mailing Address
-- LISA ELLISBELLO
1477 LINCOLN AVENUE
SAN RAFAEL, CA 94903
Phone number: 415-459-2395
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