Individual
DR. MARK LYALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
610 FRANKLIN AVE, NUTLEY, NJ 07110-1244
(973) 798-2536
Mailing address
610 FRANKLIN AVENUE, NUTLEY, NJ 07110
(973) 798-2536
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SL00514400
NJ
Other
Enumeration date
07/02/2014
Last updated
08/14/2014
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