Individual
LISA COLLICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5922 NW HANN DR, PORT ST LUCIE, FL 34986-3846
(516) 203-6760
Mailing address
5922 NW HANN DR, PORT ST LUCIE, FL 34986-3846
(516) 203-6760
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
032835-01
NY
225700000X
Massage Therapist
Primary
MA98773
FL
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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