| Lisa Mustillo Psychotherapy | |
|
1301 Shiloh Rd Nw Ste 860 Kennesaw GA 30144-7174 | |
| (917) 992-7896 | |
| Not Available |
| Full Name | Lisa Mustillo Psychotherapy |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1301 Shiloh Rd Nw Ste 860, Kennesaw, Georgia |
| Authorized Official Name and Position | Lisa Mustillo (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9179927896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Mustillo Psychotherapy 180 Montgomery St Ne Marietta GA 30060-1440 Ph: (917) 992-7896 | Lisa Mustillo Psychotherapy 1301 Shiloh Rd Nw Ste 860 Kennesaw GA 30144-7174 Ph: (917) 992-7896 |
| NPI Number | 1275277782 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 08/09/2022 |
| Certification Date | 08/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275277782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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