Provider Demographics
NPI:1629307467
Name:MONACELLO, LISA A (BA, MA)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:MONACELLO
Suffix:
Gender:F
Credentials:BA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4219
Mailing Address - Country:US
Mailing Address - Phone:610-356-2577
Mailing Address - Fax:
Practice Address - Street 1:24 SURREY DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4219
Practice Address - Country:US
Practice Address - Phone:610-356-2577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst