Individual
TARA MARIE LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LPC
Contact information
Practice address
1610 ROUTE 88 W, BRICK, NJ 08724-3018
(732) 295-6543
Mailing address
1610 ROUTE 88 W, BRICK, NJ 08724-3018
(732) 295-6543
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00491300
NJ
Other
Enumeration date
06/09/2008
Last updated
09/22/2022
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