| Doctor Name: | DR. LILY JOANN CORSELLO |
| NPI Number: | 1821162363 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.MIN |
| License Number: | 13064 |
| Business Practice Address: | 100 County Rd Big Pine Key, FL - 330434823 |
| Business Phone Number: | 9548228874 |
| Business Fax Number: | 3057417971 |
| Mailing Address: | 27332 Dominica Ln, RAMROD KEY |
| State: | FL |
| Postal Code: | 330425453 |
| Phone Number: | 9548228874 |
| Fax Number: | 3057417971 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 07/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 13064 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |