Individual
MRS. LISA ANN PHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2708 NE 14TH ST, SUITE 5, POMPANO BEACH, FL 33062-3565
(888) 880-9270
Mailing address
820 AVANT CT, VIRGINIA BEACH, VA 23454-6936
(757) 376-0826
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PGP-504561
VA
Other
Enumeration date
01/01/2013
Last updated
01/01/2013
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