Individual
MS. LISA MARIA IERACI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A, LCAT
Contact information
Practice address
243-02 NORTHERN BLVD, DOUGLASTON, NY 11362
(718) 423-6200
Mailing address
195-06A 39TH AVE, AUBURNDALE, NY 11358
(718) 423-6200
Taxonomy
Speciality
Code
Description
License number
State
102X00000X
Poetry Therapist
Primary
000069-1
NY
Other
Enumeration date
10/22/2011
Last updated
10/22/2011
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