Individual
MRS. LISA MONTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 BROADWAY, LORAIN, OH 44052-5542
(440) 233-5412
Mailing address
4700 BROADWAY, LORAIN, OH 44052-5542
(440) 233-5412
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
UA1013493
OH
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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