Most Relevant Information
Provider Data
| NPI Number: | 1003495649 |
| Provider Name: | LISSETTE MALIZA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/02/2021 |
| Last Updated: | 04/02/2021 |
Provider Practice Location
650 W 42ND ST
NEW YORK
NY
100361138
Practice Location Phone/Fax
| Phone: | 6462380238 |
| Fax: |
Provider Mailing Location
6139 MADISON ST APT 2R
RIDGEWOOD
NY
113854000
Provider Mailing Phone/Fax
| Phone: | 6462380238 |
| Fax: |