Individual
MS. JESSICA LAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1479 COLLINS AVE, MARYSVILLE, OH 43040-8808
(937) 642-1065
Mailing address
35 LOTSPEICH AVE, LONDON, OH 43140-1230
(216) 513-6019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1600119
OH
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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