Individual
MARY BRIGID LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 ORCHARD LN, SOUTH ST PAUL, MN 55075-1811
(651) 306-9529
Mailing address
419 ORCHARD LN, SOUTH ST PAUL, MN 55075-1811
(651) 306-9529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102830
MN
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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