Individual
DIANE M. LICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
550 W MAIN ST, BOONTON, NJ 07005-1168
(973) 402-9360
(973) 402-7371
Mailing address
52 LAKE SHORE DR, MONTVILLE, NJ 07045-9721
(973) 402-9360
(973) 402-7371
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00074500
NJ
Other
Enumeration date
11/12/2006
Last updated
07/08/2007
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