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1942786868
LYDIA CARISSA PONGO
SAINT JOSEPH, MI
NPI
1942786868
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MI 6401016718)
Enumeration Date
2018-07-13
Last Update Date
2018-07-13
Business Address
LYDIA CARISSA PONGO LLPC
830 PLEASANT ST
SAINT JOSEPH, MI 49085-1102
Phone number: 269-982-3832
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Mailing Address
LYDIA CARISSA PONGO LLPC
4384 LAUREL DR
SAINT JOSEPH, MI 49085-9311
Phone number: 269-982-3832
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