Individual
LISA TRUCIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 PASADENA PL, HAWTHORNE, NJ 07506-2805
(973) 800-9158
Mailing address
155 PASADENA PL, HAWTHORNE, NJ 07506-2805
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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