Individual
LISA WHITEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
10 ROUTE 209, PORT JERVIS, NY 12771-3920
(845) 858-3100
(845) 858-2894
Mailing address
10 ROUTE 209, PORT JERVIS, NY 12771-3920
(845) 858-3100
(845) 858-2894
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
R043872-1
NY
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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