Individual
MISS LISA MARIE WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASW MAANAGER
Contact information
Practice address
2795 RICHMOND AVE, STATEN ISLAND, NY 10314
(718) 982-6982
(718) 982-6916
Mailing address
2795 RICHMOND AVE, STATEN ISLAND, NY 10314
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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