Organization
LMI PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA M ILARIA PSYD (OWNER)
(973) 983-3762
Entity
Organization
Contact information
Practice address
105 GROVE ST STE 14-3, MONTCLAIR, NJ 07042-4051
(503) 307-0754
Mailing address
80 GROVE ST, MONTCLAIR, NJ 07042-3708
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
08/02/2021
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