Individual
LISA MARIE GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
3 COMMERCIAL PL, NEWBURGH, NY 12550-5306
(845) 220-2146
(845) 561-3913
Mailing address
3 COMMERCIAL PL, NEWBURGH, NY 12550-5306
(845) 220-2146
(845) 561-3913
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30972
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30972
—
NY
Enumeration date
06/12/2020
Last updated
06/12/2020
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