Provider Demographics
NPI:1215511183
Name:PAGLIERANI, LISA MICHELLE (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MICHELLE
Last Name:PAGLIERANI
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5491
Mailing Address - Country:US
Mailing Address - Phone:617-667-2636
Mailing Address - Fax:
Practice Address - Street 1:1681 BROWNFIELD ROAD
Practice Address - Street 2:
Practice Address - City:CENTER CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03813-4720
Practice Address - Country:US
Practice Address - Phone:603-662-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0096170300000X
CAGC000937170300000X
VA0139000125170300000X
UT10611248-3601170300000X
CTGC.000334170300000X
MAGC404170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAGC404OtherGENETIC COUNSELING LICENSE
NH0096OtherGENETIC COUNSELING LICENSE