Individual
LISA MOFFATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 SHARRON AVE, PLATTSBURGH, NY 12901-4700
(518) 561-1447
(518) 562-8812
Mailing address
3455 STATE ROUTE 9, PERU, NY 12972-5025
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
12/14/2021
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