Individual
LISA CHRISTINE VICENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
435 E 119TH ST, NEW YORK, NY 10035-3627
(212) 360-4002
(212) 360-4012
Mailing address
435 E 119TH ST, NEW YORK, NY 10035-3627
(212) 360-4002
(212) 360-4012
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29072
NY
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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