Individual
MRS. LISA HARMON MOLLICONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,, LCADC, ICPS CJC
Contact information
Practice address
205 ROUTE 9 N, SUITE 26, FREEHOLD, NJ 07728-8561
(732) 642-5631
Mailing address
205 ROUTE 9 NORTH SUITE 26, FREEHOLD, NJ 07728-3068
(732) 642-5631
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00076900
NJ
Other
Enumeration date
12/15/2006
Last updated
10/31/2013
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