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Individual
LISA M. FEDOCE
Active
Individual
LISA M. FEDOCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
04/06/2007
Last updated
05/19/2010
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