Individual
LISA A. DIMITRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
755 MAIN ST STE 3, OAKDALE, NY 11769-1801
(631) 678-7170
(631) 224-8940
Mailing address
116 BILTMORE AVE, OAKDALE, NY 11769-1157
(631) 678-7170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R074292-1
NY
101YS0200X
School Counselor
Primary
074292-1
NY
Other
Enumeration date
10/31/2011
Last updated
01/22/2024
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