Individual
MS. LISA FRACICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC, LGPAT
Contact information
Practice address
2511 STADIUM DR, CHARLESTON, SC 29406-6606
(816) 752-6631
(844) 919-1630
Mailing address
803 S ROSE ST, BALTIMORE, MD 21224-3740
(816) 752-6631
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC12493
MD
221700000X
Art Therapist
ATG239
MD
Other
Enumeration date
05/15/2020
Last updated
10/31/2023
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