Individual
MRS. LISA CALABRESE DODGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
(973) 316-1894
(973) 316-1829
Mailing address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
(973) 316-1894
(973) 316-1829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4138601
—
NJ
Enumeration date
10/28/2009
Last updated
10/28/2009
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