Individual
LISA M ILARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
105 GROVE ST STE 14-3, MONTCLAIR, NJ 07042-4051
(973) 983-3762
Mailing address
80 GROVE ST, MONTCLAIR, NJ 07042-3708
(503) 307-0754
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
017917-1
NY
103TC0700X
Clinical Psychologist
Primary
35SI00482800
NJ
Other
Enumeration date
12/09/2008
Last updated
06/18/2021
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