Individual
MS. LISETTE INES PURVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1248 MAGNOLIA AVE, CAMDEN, NJ 08103-2824
(856) 655-6288
Mailing address
1248 MAGNOLIA AVE, CAMDEN, NJ 08103-2824
(973) 698-5733
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
03/15/2023
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