Individual
MRS. LISA CENTENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
2025 HAMBURG TPKE, WAYNE, NJ 07470-6260
(973) 831-0006
Mailing address
421 A CENTRE ST., NUTLEY, NJ 07110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00209900
NJ
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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