Individual
BREANNE LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
48 PALM ST, NEWARK, NJ 07106-1118
(973) 878-5120
Mailing address
48 PALM ST, NEWARK, NJ 07106-1118
(973) 878-5120
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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