Individual
LISA MIRABILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
15 MAIDEN LN STE 1405, NEW YORK, NY 10038-5113
(347) 927-6896
Mailing address
15 MAIDEN LN STE 1405, NEW YORK, NY 10038-5113
(347) 927-6896
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002445-01
NY
Other
Enumeration date
08/19/2020
Last updated
03/03/2021
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