| NPI | 1659523769 |
|---|---|
| Former Name | LISA MARIE CORALLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2019-10-08 |