Individual
MRS. LISA A IANITELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
658 E. MAIN ST, CENTERVILLE, MI 49032
(269) 467-9045
Mailing address
658 E. MAIN ST, CENTERVILLE, MI 49032
(269) 467-9045
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401015504
MI
Other
Enumeration date
07/13/2016
Last updated
08/11/2023
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