Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 5115 | NJ |
NPI | 1063836047 |
---|---|
Provider Name | Dr. Lisa Maria Ciraco |
First Address | Parlin, NJ 08859 |
Second Address | Parlin, NJ 08859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2014 |
Last Update Date | 11/02/2014 |