Provider Demographics
NPI:1922155480
Name:MEILI, LARA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LARA
Middle Name:
Last Name:MEILI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 PARK GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4472
Mailing Address - Country:US
Mailing Address - Phone:804-553-4639
Mailing Address - Fax:
Practice Address - Street 1:1503 SANTA ROSA RD
Practice Address - Street 2:SUITE 105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5105
Practice Address - Country:US
Practice Address - Phone:804-673-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA249151OtherANTHEM