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General NPI Number Information
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NPI Number | 1619540549
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Entity Type | Individual
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Provider Name | MRS. LISA EMRALINO
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Gender | Female
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 1430 CEDAR ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-5012
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Country | US
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Telephone | 202-497-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 2647 SHADYSIDE AVE APT T2
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City | SUITLAND
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State | MD
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Zip | 20746-5014
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Country | US
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Telephone | 240-755-9329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 101Y00000X
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License Number State | DC
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