| NPI | 1528439387 |
|---|---|
| Former Name | LISA MARINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 8479511-6006) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2023-05-18 |